The Latin phrase "primum non nocere," or its English translation "first, do no harm," is a centuries-old medical lesson reminding us to always consider the possibility that a medical intervention might cause more harm than good. Unfortunately, despite the relevance and wisdom of this simple maxim, the notion that it may be better not to do something got sidelined as the nation's health care system became increasingly overrun by consumerism and litigation.

Today, the overuse and misuse of medical tests and treatments has resulted in the proliferation of unnecessary medical care that is inflating health care costs to an unsustainable level and putting patients in harm's way from overtreatment. The reality we are now faced with is a health care system crumbling under its own weight begging for our attention.

To reverse this crippling trend, change on almost every front will be needed. We must dispel long-held beliefs that "more care = better care." Medical educators must convey to students the importance of knowing what care is appropriate and "high value." Physicians will need to practice in an environment without the fear of impending lawsuits for not providing "enough care," and patients educated via the internet who request "more care" will need to be part of a new dialogue between patients and physicians. And finally, profit-driven motives for excessive testing will have to be replaced with more equitable and fair reimbursement policies.

Our mission, should we choose to accept it …

As ACP's Executive Vice President and CEO, I am honored to serve an organization that is working on behalf of the entire internal medicine community. As internists, subspecialists, educators, residents and fellows, allied health professionals, and medical students, we are on the front lines of health care and thus well-positioned to help turn the tide to achieve the "triple aim"—improved patient care, better health for the population, and lower per capita costs.

In response to the challenge, three years ago ACP launched its High Value Care initiative, a hybrid of clinical, educational, and policy recommendations that identify unnecessary tests and procedures. Since its inception, our initiative has gained significant momentum. This year we unveiled our High Value Care website; developed a teaching curriculum for resident training programs; produced several clinical guidelines, policies, and recommendations; and disseminated those recommendations through articles in Annals of Internal Medicine, ACP's Medical Knowledge Self-Assessment Program (MKSAP), our educational meetings, and several patient guidebooks.

The times they are a changin'

In addition to the onslaught of spiraling health care costs, the nation's population is aging and chronic disease is growing at an alarming rate, at the same time we are facing a shortage of primary care physicians. It is essentially "the perfect storm." To help right the ship, the focus on High Value Care, recognition of the importance of patient engagement, and a shift toward team-based care have emerged as the central components of a new health care paradigm.

ACP is committed to helping members stay ahead of the curve on all issues related to patient care, practice improvement, and health care reform. As the premier developer and provider of educational and clinical resources for internal medicine specialists, subspecialists, and trainees, ACP is continually expanding the scope of its educational products, publications, and clinical guidelines and finding innovative ways to deliver their content. In the area of practice improvement, we are helping physicians meet their practice requirements, report quality of care measures, adopt meaningful use of electronic health records, and transform their practices into patient-centered medical homes.

Our efforts to improve the environment of medicine are equally extensive. We continue to advocate for expanded coverage under the mandate of the Affordable Care Act, as well as to eliminate Medicare's SGR formula, reverse the shortage of primary care physicians, and reform medical liability. We are also collaborating with other health care stakeholders, including patients, subspecialists, allied health professionals, industry, and the international community to promote the value of internal medicine and achieve our health care reform goals.