Medical Organizations Acknowledge Overtreatment Is a Problem

April 5, 2012 Updated: April 9, 2012
A pediatrician gives an HPV vaccination to a 13-year-old girl in her office at the Miller School of Medicine on September 21, 2011 in Miami, Florida.
A pediatrician gives an HPV vaccination to a 13-year-old girl in her office at the Miller School of Medicine on Sept. 21, 2011, in Miami, Florida. According to some medical professionals, at least 45 tests and procedures routinely performed on patients across a range of fields are often unnecessary and may in fact be harmful. (Joe Raedle/Getty Images)

At least 45 tests and procedures routinely performed on patients across a range of fields are often unnecessary and may in fact be harmful, a group of leading medical organizations in the United States said Wednesday.

“Many of the things that are routinely done are things that patients have come to expect and doctors have routinely ordered,” said Dr. Christine Cassel, president and CEO of the American Board of Internal Medicine (ABIM). “These are not things that should never be done, but they are things that are often overused.”

The tests include brain-imaging scans, which are often given unnecessarily after fainting or headaches, CT scans or antibiotics for chronic sinusitis, and routine cancer screening tests when there are no signs or symptoms of cancer.

Nine specialty physicians groups have compiled a list in their respective fields, titled “Five Things Physicians and Patients Should Question.” They say this is an endeavor to reduce costs and unnecessary harm while encouraging a deeper conversation between patients and physicians.

The lists were compiled in a report released by the nine groups in conjunction with the Consumers Union, and the AMIB Foundation, at the National Press Club in Washington, D.C., Wednesday, April 4.

The initiative is part of the ABIM Foundation’s Choosing Wisely Program, which lists on its website the 45 routine tests and procedures in question.

“We support the goal of the Choosing Wisely campaign and hope that it will lead to better shared decision making between patients and their physicians and, ultimately, a reduction in unnecessary or harmful medical procedures,” said Dr. Steven Weinberger from the American College of Physicians.

Dr. Christine Cassel, president and CEO of the American Internal Board of Medicine Foundation, speaks at the National Press Club in Washington on April 4. Shar Adams/The Epoch Times
Dr. Christine Cassel, president and CEO of the American Board of Internal Medicine, speaks at the National Press Club in Washington, D.C., on April 4. Shar Adams/The Epoch Times

The group includes the American colleges of cardiology, physicians, and radiology; the American societies of clinical oncology, nephrology, and nuclear cardiology; and the American Academy of Family Physicians.

The American Academy of Family Physicians includes imaging for low back pain within the first six weeks as questionable. Low back pain is the fifth most common reason for all physician visits but “imaging of the lower spine before six weeks does not improve outcomes,” the organization says.

Pap smears in women younger than 21 years are also questioned. Adolescent abnormalities can be harmless and regress, the organization says, while Pap smears can lead to unnecessary anxiety, additional testing, and cost.

James Guest, president and CEO of Consumer Reports, the Consumers Union publication, welcomed the list saying not only will it lead to easier access to information and increase discussions between doctors and patients, but it will also reduce the harmful effects of overtreatment—particularly from X-rays, MRI (magnetic resonance imaging), and CAT scans.

Guest pointed to false positives in unnecessary testing, which can then result in more unnecessary tests.

“There is no real justification in the first place, so it becomes likes a snowballing effect that, I think, needs to be avoided,” he told The Epoch Times.

Guest said he was seeing a change in the culture of physicians, particularly in medical schools, from one “that doctor is God” to a great awareness of the role as “providing a service to the patient.”

“I am certainly hearing more and more doctors saying we need to be patient oriented, ‘the patient comes first’ and I think often they don’t quite realize what that is, but that is beginning to change,” he said.

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