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USA Today/ - News, Qua, 04 de Abril de 2012
CLIPPING INTERNACIONAL (Supreme Court)
Coalition of medical societies urges
questioning treatments
Physicians and patients should question some
commonly used tests and treatments that often are
unnecessary, 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 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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