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Friday, April 6, 2012

Choosing wisely: Five services that merit extra scrutiny

As part of a national campaign called Choosing Wisely, the American Academy of Family Physicians this week released a list of five tests and treatments that family physicians should think twice before performing, ordering, or prescribing:

• Don't do imaging for low back pain within the first six weeks unless red flags are present.

• Don't routinely prescribe antibiotics for acute mild-to-moderate sinusitis unless symptoms last for 7 or more days OR symptoms worsen after initial clinical improvement.

• Don't use DEXA screening for osteoporosis in women under age 65 or men under 70 with no risk factors.

• Don't order annual electrocardiograms (EKGs) or any other cardiac screening for low-risk patients without symptoms.

• Don't perform Pap smears for women under the age of 21 or those who have had a hysterectomy for non-cancer disease.

The AAFP is one of nine specialty societies taking part in the Choosing Wisely initiative, which the American Board of Internal Medicine Foundation spearheaded. The purpose of the initiative is to encourage and facilitate discussions between physicians and patients about the potential for overuse or misuse of health care resources. Learn more about the AAFP's involvement in the Choosing Wisely campaign in AAFP News Now.

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