It is now estimated that 30% of the money Americans spend on health care is wasted. As a result, an increasing number of medical organization and patient advocacy groups have banded together to create the Choosing Wisely® campaign to encourage more dialogue between patients and their physicians regarding treatment.
In line with this movement to reform medical practices, physicians from 17 leading specialty organizations have produced lists with 90 medical tests; treatments and procedures that they state patients do not need in the hope of providing better care for patients. This is the second consecutive year the list has been issued.
“We hope that both doctors and patients come to understand that more is not always better,” commented Dr. Daniel Wolfson, executive vice president of the American Board of Internal Medicine Foundation, co-sponsor of a campaign to limit unnecessary medical care.
Procedures on the list include a warning from the Academy of Family Physicians not to use MRIs for lower back pain within the first six weeks of onset as well as a warning by the American Academy of Neurology not to prescribe narcotics to treat migraines.
“Opoid medications can make the headache worse,” stated Dr. Brian Durkin, director of the Center for Pain Management at Stony Brook University Hospital. “These medications work well for fractures, but they don’t work well for nerve pain. When you take a narcotic, you increase the fluid volume in your brain and the brain, itself, is an enclosed capsule.”
Other “don’ts” listed are: Do not treat sinusitis with antibiotics; Do not give cough or cold medicine to children under 4 years of age; Don’t perform population-based screening for vitamin D deficiency; Don't bother to use feeding tubes in patients with advanced dementia; Do not schedule non-medically indicated labor or caesarians before 39 weeks of pregnancy; and Don’t perform routine annual pap tests in women aged 30-65. In average-risk women, annual tests offer no advantage over screenings done over 3-year intervals, etc.
In addition, the American Academy of Ophthalmology warned doctors not to prescribe antibiotics to treat pink eye, since 90% of infections turn out to be viral, not bacterial, and antibiotics have not affect on viruses.
Form more information regarding participating medical organizationas and additional recommendations readers can go online to http://www.choosingwisely.org/