SALON

Thursday, Feb 21, 2013 5:15 AM UTC

Doc groups issue list of overused tests, therapies

By

Topics: From the Wires, ,

WASHINGTON (AP) — 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 dozens of tests and treatments that physicians too often prescribe when they shouldn’t.

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 examples, 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.

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.

___

Online:

http://www.choosingwisely.org

More By Lauran Neergaard.

Next Article

Related Stories

More Related Stories

Featured Slide Shows

The week in 10 pics

close X
  • Share on Twitter
  • Share on Facebook
  • Thumbnails
  • Fullscreen
  • 1 of 11
  • A missing poster hangs on a tree outside the Cleveland home of Amanda Berry Wednesday. Berry and two other women, Michelle Knight and Gina DeJesus, made a daring escape this week after being held captive for more than a decade.
    Credit: AP/Tony Dejak

  • Elvis Rafael Rodriguez and Emir Yasser Yeje offer their best impression of  Eric B. & Rakim. On Thursday, New York prosecutors identified the pair as members of an international gang that robbed $45 million in a matter of hours by hacking into a database of prepaid debit cards and draining ATM machines around the world.
    Credit: AP

  • New Jersey Gov. Chris Christie walks to a podium during the groundbreaking ceremony for the Technology Enhanced Accelerated Learning Center at Essex County Newark Tech in Newark, N.J., Tuesday. Christie made less flattering headlines this week after undergoing a secret stomach surgery to curb his weight.
    Credit: AP/Julio Cortez

  • Workers stand outside the Tung Hai Sweater Ltd. factory in Dhaka, Bangladesh, Thursday after a fire broke out in its 11-story building. Eight people were killed in the blaze.
    Credit: AP/Ismail Ferdous

  • Workers rescue a woman trapped for 17 days in the rubble of a garment factory building in Saver, Bangladesh, Friday. The building's collapse was the worst industrial disaster in the country's history, killing more than 1,000 people.
    Credit: AP

  • Former South Carolina Gov. Mark Sanford gives his victory speech Tuesday in Mt. Pleasant, S.C., after winning back his old congressional seat in the state's first district.
    Credit: AP/Rainier Ehrhardt

  • Jodi Arias reacts in Maricopa Country Superior Court Wednesday after being found guilty of first-degree murder in the gruesome killing of her one-time boyfriend, Travis Alexander. Arias has subsequently said she wants the death penalty, claiming she'd "prefer to die sooner than later."
    Credit: AP/The Arizona Republic/Rob Schumacher

  • Ariel Castro stands for his mug shot Thursday at the Cuyahoga County Corrections Center, where he is being held on $8 million bail. The former bus driver is accused of imprisoning three young women and beating them repeatedly over a period of 10 years.
    Credit: AP/Cuyahoga County

  • Charles Ramsey addresses the media Monday after helping rescue three women held captive in Cleveland for more than a decade. Ramsey's hero portraiture has been complicated by revelations of his own domestic violence record.
    Credit: AP/The Plain Dealer/Scott Shaw

  • Michael B. Donley, Secretary of the Air Force, testifies during a Senate Appropriations Defense Subcommittee hearing on Capitol Hill Wednesday. The military branch was rocked this week after its chief sexual assault prevention officer was charged with sexual battery.
    Credit: AP/Carolyn Kaster

  • Recent Slide Shows

  • Share on Twitter
  • Share on Facebook
  • Thumbnails
  • Fullscreen
  • 1 of 11

Related Videos

Comments

 0 Comments

Comment Preview

Your name will appear as username

You may use these HTML tags and attributes: <a href=""> <b> <em> <strong> <i> <blockquote>

follow salon

Most Read

Popular on Reddit

links from salon.com

From Around the Web

Presented by Scribol
listener_new_rect The Listener: So long, Sookie Stackhouse

Recommendations