Doctor Groups Urge Fewer Tests

A regular checkup is always appropriate for keeping your health in check, but your doctor could be overdoing it, as new guidelines from prominent medical associations suggest.

Unnecessary exams and procedures could do more harm than good for both physicians and patients, and more medical specialty groups are stepping up to do something about it.

Just last year, the American Board of Internal Medicine and Consumer Reports launched the “Choosing Wisely” campaign to reduce unnecessary medical initiatives for patients. The campaign seeks to inform doctors and the public about exams and procedures that are potentially unnecessary, harmful, or lack enough medical evidence to justify their use. 

“Twenty-five of the nation’s leading medical specialty societies have now spoken up and shown leadership by identifying what tests and treatments are common to their profession, but not always beneficial,” said Christine K. Cassel, M.D., president and CEO of the ABIM Foundation for medical professionalism, in a press release. “Millions of Americans are increasingly realizing that when it comes to health care, more is not necessarily better. Through these lists of tests and procedures, we hope to encourage conversations between physicians and patients about what care they truly need.”

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Key recommendations from the medical groups include:

  • Don’t perform Pap tests on women younger than 21 and those who have had a hysterectomy for a non-cancer disease.  
  • Antibiotics should not be used for apparent viral respiratory illnesses like sinusitis, pharyngitis, and bronchitis.
  • The infection known as "swimmer's ear" should be treated with ear drops, not oral antibiotics.
  • Don’t use antipsychotics as the first choice to treat behavioral and psychological symptoms of dementia.  
  • Don’t perform stress cardiac imaging tests or advanced non-invasive imaging tests during the initial evaluation of patients without cardiac symptoms, unless high-risk markers for heart disease are present.
  • Don’t use opioid pain medications like Vicodin to treat migraine headaches, except as a last resort.
  • Don’t induce labor or jump straight to a C-section just because a pregnant woman misses her due date.
  • CT scans are not necessary to diagnose abdominal pain in children.
  • Don’t use glucose-regulating drugs to maintain tight control of blood sugar levels in older adults with type 2 diabetes.

Why Less Is More

You might think it’s better to be safe than sorry when accepting additional exams and treatments, but excess testing could hurt you in more ways than one.

These redundant tests are a huge pain in the pocketbook. Hospitals and patients waste valuable time and materials on extraneous procedures, which leads to rising health care costs that weigh heavily on the consumer. A sizeable chunk of the $750 billion the U.S. healthcare system wastes each year is from unnecessary services.

Many exams are performed infrequently for good reason. People often overreact to common abnormal results from exams such as Pap tests, giving them incorrect information about the state of their health and keeping them in the exam room for longer. There’s a feeling of safety in overtreatment that keeps some patients going back for peace of mind, even when it offers no real benefit. 

There’s also a simple reason why physicians should perform certain tests as little as possible, within the bounds of safety: Sometimes they’re downright risky, as in the case of elective spinal stenosis surgery, which may involve fusing portions of a patient’s spine. It would be impractical and unsafe for doctors to opt for this procedure except as a last resort.

It seems counterintuitive, but don’t bother getting what you don’t absolutely need. It’s not about under-treatment, but about getting the appropriate amount of treatment for each individual.  

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Starting a Dialogue with Your Doctor

One goal of the “Choose Wisely” campaign is to foster a productive conversation among physicians and patients to ensure that both sides are satisfied. The updated recommendations give both parties a point of reference, and will make it easier to ask your doctor informed questions.

If you think you may need a particular exam, you can refer to the guidelines and ask your doctor about the best course of action.

Talk to your doctor about the treatments you’re receiving. If you are uncomfortable or uncertain about a doctor’s recommendation, you have the right to ask for clarification. The doctor-patient relationship should be one of openness and trust.

How Can I Avoid Unnecessary Tests and Procedures?

These new testing recommendations exist to put you in control. Take charge, and participate in the decisions being made about your health.

Hopefully, the recommendations will also help you carefully consider what you hear about health in the media and in your circle of friends. You’ll be better prepared to make choices about your health when you’re armed with the facts:

  • Certain exams are only necessary and useful at particular points in a person’s life. If you’re not due for one, save the trip to the doctor unless you’re experiencing symptoms.
  • While it’s tempting to go online and find a million screening tests to take, unless you’re a medical professional, don’t act as your own doctor.
  • Be wary of advice about trendy diets and other health fads. There’s no need to convince yourself that you suffer from something you likely don’t have.

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