FYI Daily

Docs Say, Cut Unnecessary Medical Care

Last updated: Apr 05, 2012

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Ever wonder why certain tests are ordered on autopilot? Or whether your loved one really needed a specific procedure? The "throw everything at the problem -- even if it probably won't do any good" days are being increasingly questioned as healthcare costs spiral and patients are often made sicker by excessive care. Now doctors in nine different national specialty groups have created a campaign to help cut back on 45 different diagnostic tests, procedures, and treatments that often provide patients little benefit.

The "Choosing Wisely" project was launched last year by the American Board of Internal Medicine (ABIM) Foundation, reports NPR. More than 376,000 physicians in specialty-practice groups -- family physicians, cardiologists, radiologists, gastroenterologists, oncologists, kidney specialists and specialists in allergy, asthma, immunology, and nuclear cardiology -- were asked to come up with five common tests or procedures "whose necessity ... should be questioned and discussed."

You can see their recommendations -- 9 lists of "5 things physicians and patients should question" -- at the Choosing Wisely website. Some examples:

  • Don't do imaging for low back pain within the first six weeks unless certain red flags are present (such as progressive neurological problems).

  • Postpone repeat colonoscopies for 10 years if the first one is negative or if it found and removed one or two early-stage colon polyps.

  • Don't perform routine cancer screening for dialysis patients with limited life expectancies without signs or symptoms.

  • Don't give more chemotherapy to patients who are debilitated with advanced cancer to the point of being bedbound and unable to walk or manage self care.

"There will be some ... that may demonize this campaign and infer the R-word "” rationing," says Daniel Wolfson of the ABIM Foundation. But rationing is the denial of care that patients need, he added. The Choosing Wisely effort aims to reduce care that has no value.

Doctors evidently agree with that interpretation. This fall eight more specialty groups will join the campaign: hospice doctors, head and neck specialists, arthritis doctors, geriatricians, pathologists, hospital practitioners, nuclear medicine specialists, and those who perform echocardiography (a heart test).

Image by Flickr user clevercupcakes, used under a Creative Commons license.