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Physician Groups Identify Tests and Procedures That are Often Not Necessary

Nine physician organizations have each identified five tests or procedures that may be overused or unnecessary as part of the Choosing Wisely campaign led by the ABIM Foundation, with Consumer Reports, in an effort to improve health care quality and patient safety.

Patient advocates are calling the move a significant step toward improving the quality and safety of health care.

As the nation increasingly focuses on ways to provide safer, higher-quality care to patients, the overuse of healthcare resources is an issue of considerable concern. Many experts agree that the current way health care isdelivered in the U.S. contains too much waste – with some stating that as much as 30 percent of care delivered isduplicative or unnecessary and may not improve people’s health. In fact, such unnecessary care may harm orhinder patients’ health. 

What can employers do with this information? Two steps you can take now include:

Build this information into your employee communication campaigns. Armed with this information, employees can have important discussions with their physicians and avoid tests or procedures that add no clinical value and save costs. MBGH is incorporating this information into our "Getting Quality Care" tool kit to make it easy for our members to present this information to your employees.

Talk with your health plan about how they plan to incorporate the lists into their decision support tools, coaching, disease management and utilization management programs. Ask them how these lists are being addressed in their patient-centered medical home practices. Get details on how the health plan is communicating with their physician network about these lists.

Examples from the lists of “Five Things Physicians and Patients Should Question” include:

  1. Do patients need brain imaging scans like a computed tomography (CT) or magnetic resonance imaging (MRI) after fainting, also known as simple syncope? Probably not. Research has shown that, with no evidence of seizure or other neurologic symptoms during an exam, patient outcomes are not improved with brain imaging studies. (American College of Physicians).· Do patients need electrocardiograms (EKGs) and stress tests for annual checkups? Not if you are an otherwise healthy adult without cardiac symptoms. These tests rarely result in any meaningful change in patient management. (American College of Cardiology)
  2. Should patients going into outpatient surgery receive a chest x-ray beforehand? If the patient has an unremarkable history and physical exam, then no. Most of the time these images will not result in a change in management and has not been shown to improve patient outcomes. (American College of Radiology)
  3. Do patients need a CT scan or antibiotics for chronic sinusitis? Most acute rhinosinusitis resolves without treatment in two weeks and when uncomplicated is generally diagnosed clinically and does not require a sinus CT scan or other imaging. (American Academy of Allergy, Asthma & Immunology)
  4. Should dialysis patients who have limited life expectancies and no signs or symptoms of cancer get routine cancer screening tests? These tests do not improve survival in dialysis patients with limited life expectancies, and can cause false positives which might lead to harm, over treatment and unnecessary stress. (American Society of Nephrology)
  5. Should women under 65 or men under 70 be screened for osteoporosis with dual energy x-ray absorptiometry (DEXA)? No, research has shown that in patients with no risk factors DEXA screening is not helpful in this age group. (American Academy of Family Physicians)

The complete lists from the specialty societies are available below and include additional detail and evidentiary information communicating when a particular test or treatment may be appropriate based on clinical evidence and guidelines.

Learn more at www.choosingwisely.org

Allergy & Asthma
Radiology
Nephrology
Nuclear Cardiology
Clinical Oncology
Gastroenterology
Internal Medicine
Cardiology
Family Practice


 

Posted by Cristie Travis at 7:46 AM

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