There are a lot of guidelines in many specialties. You've seen how doctors and societies produce guidelines, but they often address what we should do and not what we shouldn't do. They very rarely tell you what to stop. Think of all the older patients you know who are on a zillion drugs. What happens is that they go into their doctor's office, and the next specialist adds another drug, but people rarely say, “Let's look at whether you're on too many drugs.” Stopping things is not embedded as well in our guidelines.
We think if specialists themselves look at their practices and ask themselves about the common things they do where evidence shows they might do more harm than good and start to articulate that...because we haven't really as a profession articulated what we overuse. Twenty of our societies of the 60 that are engaged—and infectious disease is definitely one of them that's been working with us—have lists that include antibiotics. A lot of them have things around opioids, the other public health issue that you're certainly worried about. There are many reasons that overusing test and treatment gets baked in, so we need to engage the profession, I think, in trying to correct that problem because it's been around for a really long time without being addressed.