Doctors spotlight dozens of overused tests, treatments

WASHINGTON Don't be afraid to question your doctor and ask, "Do I really need that?"

That's the advice from leading medical groups who came up with dozens of tests and treatments they say physicians too often prescribe when they shouldn't.

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11 medical tests, treatments you may not need

No worrisome stroke signs? Then don't screen a healthy person for a clogged neck artery, the family physicians say. It could lead to risky surgery for a blockage too small to matter.

Don't routinely try heartburn medicine for infants with reflux, the pediatric hospitalists say. It hasn't been proven to work in babies, and could cause side effects.

Don't try feeding tubes in people with advanced dementia, say the hospice providers. Helping them eat is a better option.

These are examples of potentially needless care that not only can waste money and time, but sometimes can harm, says the warning being issued Thursday from medical specialty groups that represent more than 350,000 doctors.

Too many people "think that more is better, that more treatment, more testing somehow results in better health care," said Dr. Glen Stream, former president of the American Academy of Family Physicians, which contributed to the list. "That really is not true."

The recommendations are part of a coalition called Choosing Wisely, formed by the American Board of Internal Medicine Foundation. Participating medical societies were asked to identify five tests or treatments that are commonly overused in their specialty. The list is aimed at doctors and includes references to published studies. Consumers Reports and other consumer groups are publicizing the information in more patient-friendly terms.

Last year, the coalition listed 45 overused tests and treatments. It included some of the best known procedures, such as too much imaging for back pain and repeating colonoscopies too frequently.

This year's list adds 90 more overused kinds of care. Some are the result of doctors' habits, hard to overcome despite new evidence, Stream said. Others come about because patients demand care they think they need.

9 common medical procedures you may not need

Some other examples:

Don't use opioid painkillers for migraines except as a last resort, say the neurologists. There are better, more migraine-specific drugs available without the addictive risk of narcotics. Plus, frequent use of opioids actually can worsen migraines, a concept known as rebound headache.

Just because a pregnant woman misses her due date, don't race to induce labor if mom and baby are doing fine, say the obstetricians. Inducing before the cervix is ready often fails, leading to an unneeded C-section. "Just being due by the calendar doesn't mean your body says you're due," Stream notes.

Don't automatically give a child a CT scan after a minor head injury, say the pediatricians. About half of children who go to the ER with head injuries get this radiation-heavy scan, and clinical observation first could help some who don't really need a CT avoid it.

And don't leave an implanted heart-zapping defibrillator turned on when a patient is near death, say the hospice providers. This technology clearly saves lives by guarding against an irregular heartbeat. But if someone is dying of something else, or is in the terminal stages of heart disease, it can issue repeated painful shocks, to no avail. Yet fewer than 10 percent of hospices have formal policies on when to switch off the implants.

[Katrina_Firlik]

Great article, Liz. It's so important to take steps to reduce healthcare spending. Focusing on the tests, procedures and medications as you've done here is a great first step. But it's only a piece of the larger puzzle. Many of these medical procedures you're writing about become necessary because patients don't follow their prescriptions and their conditions get worse. The New England Healthcare Institute estimated that people not following their prescriptions in the US costs $290 billion in "otherwise avoidable medical spending" each year. You're right to point to the responsibility of patients, and not just doctors, in doing their part to get healthcare spending under control. If interested, you can read more of my articles here: http://******/WZrWDR - Katrina Firlik, M.D., co-founder, HealthPrize Technologies.

[rightontarget]

I still say it's all about the MONEY!!! Medical goods and services have turned into nothing more than a product for sale. Sure physicians cover their rear ends but it is also much more difficult than you would think to prove medical malpractice. Medicine has turned into nothing more than just another "business" for profit. They never used to advertise prescription drugs on TV but now we are bombarded by those God-awful ads from the "drug pushers" to "Ask your doctor if blah, blah, medication is for you", and then they go on to list all the side affects in a very quiet voice just to cover their azzes. Jeeez... It's all about marketing. Greed has taken over everything.

[VA_Jill]

Always refuse daily lab work unless you can get a reasonable explanation for it from the doctor. Too many of them order daily labs just out of habit. I know....I'm a nurse, and I have questioned the docs myself on behalf of a patient on numerous occasions! Unfortunately, medicine as practiced in the US treats the wallet, not the patient.

[foo8259]

"Talk to your doctor"

[Transatlantique]

I hope they included infant male genital mutilation, euphemistically termed "circumcision", as one of those unnecessary procedures. Eighty five percent of men internationally get along fine without it. In fact, it is illegal when performed on a non consenting infant. The parent's wishes are irrelevant.

[democracy8]

You are always your own best advocate. Especially if your insurance is limited.

[ballwyllo]

Couldn't agree more, but this article is about Drs telling patients to watch out for other Drs ordering unneeded testss. What it fails to understand is that Drs generally are not open to conversation about the reasons for tests. The real conversations that are happening in Drs offices are much more dictatorial. Try asking any health care provider including nurses about these type things and you'll find out quickly how much they don't appreciate your "interference".

[judymar14]

Lawsuits are the reason for useless tests...How often has it been said "a simple test could have saved him/her?" Words to that affect/effect?

[VO142857]

You beat me to it.

[jschm2681]

Obamacare adds a tax on medical product manufacturers. They are already planning on shipping jobs overseas and layoffs to cut costs. Obamacare endangers innovation of products and drugs.

[nolalou2]

is a 2.5 percent excise tax, but it will increase demand for most of those products since more people will be covered by insurance.
The tax The tax applies equally to imported and domestically produced devices, so it doesn't give an advantage to foreign companies. Shipping jobs overseas won't mean they can avoid the tax. Sorry, but I don't buy your argument.

[democracy8]

nolalou2, don't try to confuse jschm2681 with facts, he's already confused enough (see below).

[outback_jackson]

Are power wheelchair companies ripping off the government?



Of course they are, just like every other GREEDY company, since it's the republiCON way -- worshiping the almighty American dollar, and stealing from our government!


On Wednesday, 150 federal and state agents raided The SCOOTER Store headquarters in New Braunfels, Texas, and agents remain on the site. CBS News just spoke to an FBI agent Thursday morning who said workers will not be allowed back into headquarters through the day as the nation's largest power wheelchair company remains under investigation.



Imagine that.....in texass of all places!

[jschm2681]

Republicans try to limit waste and fraud. Democrats seem to encourage it. This investigation is under Obama's watch, so the fraud, if there is any has been going on for Obama;s first term, undetected. Democrats want the big govt waste.

[democracy8]

jschm2681, Let me get this straight. The investigation into fraud is being conducted under Obama's watch, but you want to blame Obama for allowing fraud? Bud, you're not right in the head if that's your kind of logic. How do you know that it didn't start under another administration? Seriously, you're cuckoo!!!

[outback_jackson]

RIGHTONTARGET says: "It's all about the MONEY!! Medical goods and services have turned into just another PRODUCT to sell for profit!!!"




You're damn right it's all about MONEY and GREED -- the republiCON way -- since without a heart and soul, the GOP can only worship MONEY and bleed America dry as the anti-American terrorists they are today!