Major doctor group coalition expands list of tests, treatments that should be done only rarely

Feb 22 2013

The American Board of Internal Medicine, as part of its "Choosing Wisely" campaign, expanded the number of medical societies recommending caution before certain tests and procedures are ordered.

The Fiscal Times: Do You Really Need That Test? Doctors Warn On 90 Treatments
When it comes to medical treatment, more isn't necessarily better. Americans might not like hearing it, but that's the message from 17 separate medical societies out with a new list of 90 tests and procedures they say are commonly ordered by doctors but aren't always necessary – and may sometimes be harmful. The medical groups behind the list represent more than 350,000 physicians across a range of specialties, from family doctors and pediatricians to rheumatologists and geriatricians (Rosenberg, 2/21).

Los Angeles Times: Doctors List Overused Medical Treatments
The medical interventions -; including early caesarean deliveries, CT scans for head injuries in children and annual Pap tests for middle-aged women -; may be necessary in some cases, the physician groups said. But often they are not beneficial and may even cause harm (Levey, 2/20).

Modern Healthcare: Campaign Expands List Of Questionable Tests, Procedures
The American Board of Internal Medicine Foundation expanded its Choosing Wisely campaign ... Seventeen newly participating medical societies each submitted at least five tests or procedures to the campaign, which was launched in 2011 by the ABIM Foundation, a not-for-profit that seeks to advance medical professionalism. The campaign recommends that physicians question the more than 130 tests and procedures cited by the campaign before they are ordered (Lee, 2/21).

Reuters: Just Say Don't: Doctors Question Routine Tests And Treatments
Other specialists say no cough and cold medications for kids under 4, no oral antibiotics for acute infections of the ear canal ("swimmer's ear") and no use of drugs to keep blood sugar in older adults with type 2 diabetes within tight limits. There is no evidence that tight "glycemic control" - which is widely practiced - is beneficial, said the American Geriatrics Society. ... Some recommendations, if widely adopted, would mean significant changes in patient care. The geriatricians, for example, recommend against feeding tubes in patients with advanced dementia. The tubes hurt and cause problems; carefully feeding the patient is better (Begley, 2/21).

Medpage Today: 17 Doc Groups Add To 'Overused' Test List
A couple of recommendations appeared in multiple groups' lists. AAFP and ACOG both urged against scheduling elective labor inducements or cesarean deliveries before 39 weeks, since doing so is associated with an increased risk of learning disabilities, respiratory problems, and other potential problems. ... ABIM hopes to release a third list later this year which will include 13 more societies (Pittman, 2/21).

In related news --

Kaiser Health News: Hospitals Clamp Down On Dangerous Early Elective Deliveries
For decades, doctors have been warned about the dangers of delivering babies early without a medical reason. But the practice remained stubbornly persistent. Now, with pressure on doctors and hospitals from the federal government, private and public insurers and patient advocacy groups, the rate of elective deliveries before 39 weeks is dropping significantly, according to latest hospital survey from The Leapfrog Group, a coalition of some of the nation's largest corporations that buy health benefits for their employees (Galewitz, 2/21).