The Cost of Inaction

As my car maintenance light turned on a few days ago, it reminded me that it was time to go for the routine car maintenance check up.

And I learned the importance of going to car maintenance not because I always knew it was the right thing to do, but because I vividly remember when I was driving my old car with the maintenance light on for months until it started to smell like exhaust inside.

The price to fix that wasn’t cheap, all because I let a warning signal go for too long.

And that got me thinking—have you ever felt the sting because you didn’t do something when you knew you should? Or you simply let a small problem go for too long and it festered into something way bigger?

We all know there are costs to doing something. For example, starting a patient on a new medication comes with costs like:

• The drug itself

• Time spent on care planning

• Time required for the benefits to take effect

• The cost of managing potential side effects

These costs are upfront. Although some costs are not as tangible as others, we’re mostly aware of them when we make such decisions. And of course, there are also costs you don’t know about because you lack experience. And those are what I call tuition.

But the cost of not acting is more subtle. It’s the consequence that could have been avoided if action had been taken just like my old car.

In opioid management, the costs of inaction can be quite costly:

↳ Opioid fill history or the prescription drug monitoring program isn’t checked, and a wrong dose of opioid is ordered

↳ The urine drug screen isn’t done, and an opportunity to refer a patient with potential opioid use disorder is missed

↳ The counseling isn’t done, and opioid use is higher than it should be

↳ Tapering trial is never brought up, and opioid is continued at high dose indefinitely

And sometimes, the action needed isn’t the actual action itself—it can start from the very first step, which is asking the question on your team:

“Hey, do you know if we have the prescription drug monitoring note on file?”

Try asking that this week and let me know how it changes your decision making this week.