Citing unnecessary medical tests and procedures as a major driver of soaring health-care costs, a coalition of doctors groups and consumer groups Wednesday unveiled a campaign to push doctors and patients away from 45 tests or procedures that are overused and often unhelpful.
Sponsored by the American Board of Internal Medicine Foundation, the “Choosing Wisely” campaign aims to get doctors and patients talking about these procedures to achieve “better decision-making,” said Christine K. Cassel, chief executive of the ABIM.
“Patients are going to say, ‘Why can’t I have this X-ray or this CT scan, just in case?’ There’s always that ‘just in case,’ ” Cassel said. Yet studies show that the procedures on the list might harm patients instead of helping them, by delivering unnecessary radiation or leading to unnecessary surgery or other invasive procedures.
A 2005 National Academy of Sciences report found that 30 percent of U.S. health-care spending was unnecessary or wasteful; more recent studies arrive at similar figures. That amounts to a staggering $600 billion to $700 billion annually.
Here are some of the tests, medicines and procedures that, according to the campaign, “should be questioned”:
• Antibiotics for sinus infections: The vast majority of infections are not caused by bacteria
• X-rays for low back pain: Unnecessary unless “red flags” signify possible serious disease
• Stress tests for healthy people: Heart screening tests don’t make sense unless the patient has diabetes or other heart risk factors
• CT or MRI head scans for fainting: Unnecessary unless signs of a seizure are also present
• CT scans for appendicitis in children: Less expensive ultrasound scans are preferred
• Repeat colonoscopies within 10 years: For those at low to average risk for colon cancer, once a decade is enough
• PET, CT, bone scans to determine spread of early prostate and breast cancers: If tumors are low grade — meaning they present a low risk of metastasis — scans can lead to unnecessary surgery, radiation and chemotherapy.
“We’re not saying you should never do these things,” Cassel said. “We’re saying that these are things that are often overused. So, if you think you need it or your doctor recommends it, raise the question: ‘Do I really need this?’ ”
The nine doctors groups, which include 375,000 members, are: American Academy of Allergy, Asthma & Immunology; American Academy of Family Physicians; American College of Cardiology; American College of Physicians; American College of Radiology; American Gastroenterological Association; American Society of Clinical Oncology; American Society of Nephrology; American Society of Nuclear Cardiology.
Each group identified five procedures in its speciality that are overused or often unnecessary.
The entire list of 45 (often) unnecessary tests and procedures is online at choosingwisely.org