Expanded List of Unnecessary Medical Tests Aims to Reduce Healthcare Spending

The Choosing Wisely campaign, an initiative of the American Board of Internal Medicine, “is focused on encouraging physicians, patients, and other healthcare stakeholders to think and talk about medical tests and procedures that may be unnecessary, and in some instances can cause harm.” Just this week, the leaders behind this initiative added a number of “do’s” and “don’ts” to their growing list.

Since the inception of the campaign early last year, Choosing Wisely has been adopted by dozens of medical organizations. The main goal of the campaign is to get providers to help patients choose care that is defined by the following:

• Supported by evidence
• Not duplicative of other tests/procedures that have already been given to the patient
• Free from harm
• Truly necessary

A recent report by NPR outlines some of the organizational-specific interpretations of those guidelines:

Don't induce labor or perform a cesarean section for a baby who's less than full-term unless there's a valid medical reason, say the American College of Obstetrics and Gynecology and the American Academy of Family Physicians. (It can increase the risk of learning disabilities and respiratory problems.)

Don't automatically do a CT scan on a child with a minor head injury, warns the American Academy of Pediatrics. (Currently half of all such children get them, when simple observation is just as good and spares radiation risk.)

Don't try to normalize blood sugar in most patients with diabetes older than 65 years, exhorts the American Geriatrics Society. (It can lead to higher mortality rates.)

The latest addendum to the growing list brings the total number of tests and procedures that are often times unnecessary to 90. Even more impressive is that 17 organizations representing over 350,000 physicians have contributed to the list.

Click here to read more about the new additions to the list, and check out AJMC’s Panel Discussion on the treatment and cost implications of pertuzumab to hear how Sandra Swain, MD, Washington Cancer Institute, Medstar Washington Hospital Center, President, American Society of Clinical Oncology, is helping to incorporate the campaign into the day-to-day decision making of oncologists.

Around the Web

Choosing Wisely Website

Medical Waste: 90 More Don'ts For Your Doctor [NPR]