« AAFP Taking 'Watchfu... | Main | What Happens When a... »

Wednesday Apr 04, 2012

Let's Help Our Patients Make Informed Decisions on Tests, Procedures

Nearly one-third of health care delivered in the United States is unnecessary. Ordering tests or procedures that aren't recommended puts our patients at risk and drives up the already skyrocketing cost of health care, which is projected to account for nearly 20 percent of the nation's gross domestic product by the end of the decade -- unless things change.

And change is exactly what we're recommending.

Today, the AAFP released a list of five tests and treatments family physicians and our patients should question because they often are overused or misused. According to a study in the Archives of Internal Medicine, tests and procedures being overused in primary care are costing the health care system more than $6 billion a year.

One example of overuse is prescribing patterns for antibiotics. These drugs are prescribed in more than 80 percent of the 16 million annual office visits for sinusitisdespite recommendations against the practice.

The AAFP created its top five list of overused tests and treatments as part of the American Board of Internal Medicine Foundation's Choosing Wisely campaign, which is focused on identifying tests and/or procedures commonly used in medical specialties that may not always be necessary. The Academy is one of nine physician specialty organizations that initially agreed to participate in the collaboration.

The AAFP's goal in participating in the Choosing Wisely campaign is to provide evidence-based clinical information that we can use -- along with AAFP consumer education materials -- to start conversations about tests and procedures with our patients. This information will provide a solid foundation for shared decision making between us and our patients that is directed toward the best possible care while avoiding unnecessary and potentially harmful testing and treatment. It will make it easier for everyone to make the best possible choices.

Although we have taken an important step in developing our list of tests and procedures, our work is not done. In the coming weeks and months, Consumer Reports will be issuing patient education materials on each of the five issues we are addressing. As those resources are released, our Web page on the Choosing Wisely campaign will be updated.

Family physicians have a dual opportunity and responsibility regarding Choosing Wisely. First, we must use best evidence for the care we provide. And second, we must be a resource to our patients when they need subspecialty care. Many of our subspecialty colleagues are participating in the Choosing Wisely campaign as well, and I applaud them for their efforts. You can read all nine of the lists released today on a Choosing Wisely Web page.

Glen Stream, M.D., M.B.I., of Spokane, Wash., is president of the AAFP.

Comments:

1/3 of health care unneccesary? That is an underestimate. Antibiotics for viral respiratory infections, x-rays for non-traumatic pain, bp meds for patients with office hypertension, cholesterol medication for patients with less than 10% ten year risk of CV event, the annual physical....The list goes on. At least 1/2 if not 2/3 of health care could be eliminated without any increase in illness or mortality. The problem- we get paid for giving care not for discouraging waste. The Health Care Reform Act is a step in the right direction but it appears to be heading toward being declared unconstitutional by a politicized Supreme Court.

Posted by Thomas G. Smith MD on April 05, 2012 at 11:57 AM CDT #

1/3 of health care? I don't see any documentation of how they arrived at that figure. Certainly some things are unnecessary but let's be wise. The Health Care Reform Act will unfortunately decrease the accessibility to health care for many Americans.

Posted by Steve Hammer on April 07, 2012 at 09:03 PM CDT #

There are several sources that have independently arrived at the 1/3 figure. The one I found most helpful was the book, "Overtreated" by Shannon Brownlee. Regardless of the exact figure, most agree that a significant amount of health care dollars are spent on testing/treatment that doesn't benefit patients. Choosing Wisely is an effort by the medical profession to enable ourselves to be wise stewards of medical resources.

Posted by Glen Stream, MD on April 10, 2012 at 02:16 PM CDT #

You must be logged in to post a comment. Login

Want to use this article elsewhere? Get Permissions

Search This Blog


Sign Up


Subscribe to receive e-mail notifications when the blog is updated.

Email address:

Feeds

Disclaimer

The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.