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USA Today/ - News, Qua, 04 de Abril de 2012
CLIPPING INTERNACIONAL (Supreme Court)
Medical societies urges questioning
treatments
Physicians and patients should question some
commonly used tests and treatments that often are
unnecessary and costly and may in some cases be
harmful, says a report out today that's part of a new
campaign to improve care and cut waste.
Some of the recommendations have been around, but
the campaign represents a rare coordinated effort
among multiple medical societies.
Nine leading physician specialty societies — including
the American Academy of Family Physicians, the
American College of Cardiology and the American
College of Physicians — each identified five
procedures, treatments and tests (for a total of 45) that
the groups say are routinely used but may not always
be necessary. Their lists are being released today as
part of the ABIM (American Board of Internal Medicine)
Foundation's Choosing Wisely campaign
(choosingwisely.org), which is being done in
conjunction with Consumer Reports magazine.
For instance, the American College of Radiology says
people don't need routine chest X-rays before surgery
if the patient has an "unremarkable" medical history
and physical exam.
One goal of the campaign is to make people "feel
empowered to go to their doctor and say, 'Do I really
need this test?' " says Christine Cassel, president of
the ABIM and the group's foundation.
John Santa, an internist and the director of the Health
Ratings Center for Consumer Reports, says, "I think
it's courageous of cardiologists, internists and family
physicians to suggest reducing services that they know
generate income for some of their members. I'm sure
some of their members won't be happy."
Among the campaign's advice to physicians and
patients:
•Don't do imaging for lower back pain within the first six
weeks unless there are red flags, such as decreased
strength in a leg, says the American Academy of
Family Physicians. It does not improve outcomes but
does increase costs.
•There's no need to repeat colorectal cancer screening
for 10 years if a high-quality colonoscopy comes back
negative in average-risk individuals, the American
Gastroenterological Association says.
•Don't routinely prescribe antibiotics for acute
mild-to-moderate sinus infection unless symptoms last
for seven or more days, the American Academy of
Family Physicians says. Most sinusitis is due to a viral
infection and will resolve on its own.
•Don't use dual-energy x-ray absorptiometry (DEXA)
screening for osteoporosis in women younger than 65
or men younger than 70 with no risk factors, the family
physicians group says.
•Don't obtain a stress test or treadmill test for
individuals who have no symptoms of heart troubles
and are at low risk for coronary heart disease, the
American College of Physicians says.
The report's release was not timed to coincide with the
current Supreme Court debate on health-care
legislation, Cassel says. "But we live in the same
world. We all know we are paying too much on health
care. If we can cut some of our costs, then we can
have enough resources to provide health care for
those who need it."
Sidney Wolfe, an internist and director of the health
research group at Public Citizen, a consumer group,
was not involved in creating the new campaign. But he
says it is "identifying unnecessary, overused tests.
Unnecessary tests frequently lead to unnecessary
surgery or unnecessary drugs being prescribed, which
can lead to unnecessary injuries, unnecessary
surgeries and unnecessary deaths."
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