Foundation releases second list of medical 'don'ts' for America's doctors

February 25, 2013 by Anne-Kathrin Gerstlauer

Doctors should avoid 90 medical procedures that are performed regularly but often cost too much or do little good, according to a new list of expert recommendations.

The ABIM Foundation said it released its medical "don'ts" to help and patients choose wisely and reduce .

Some examples: Physicians shouldn't use feeding tubes for patients with advanced dementia or automatically order CT scans to evaluate children's minor head injuries.

"More is not always better," said Daniel Wolfson, the executive vice president of the foundation, which is affiliated with the American Board of Internal Medicine. "The current question is what not to do because it is wasteful or has side effects."

The nonprofit American Board of Internal Medicine certifies doctors of and aims to improve the quality of health care.

The list, which combined the recommendations of 17 medical groups, was released Thursday. The 90 procedures mentioned involve , neurology, gynecology, pediatrics, and other disciplines.

According to the foundation, the radiation from a can increase a child's . About 50 percent of the children who visit hospital emergency departments with head injuries have CT scans. The list recommends that doctors observe children before deciding on CT scans.

As for feeding tubes for patients with , the American Geriatrics Society says assistance in oral feeding is better, the foundation said. The society describes the treatment as more humane and comforting, since feeding tubes can be painful.

Last April, the foundation first launched a "don'ts" list that had 45 items. This week's 90 recommendations are in addition to the first 45. A third list will be published later this year.

The medical groups that participated will share the recommendations with their collective membership of 725,000 doctors.

Consumer Reports will translate the results into brochures, videos and articles for patients. The material, in Spanish as well as English, will explain the technical terms and specific recommendations with headlines such as "Allergy tests: When do I need them?" and "Hard decisions about cancer."

"Our surveys show that patients think that every screening has got to be good," said John Santa, the director of the health ratings center at . "Our health care system pays item by item. So doctors, hospitals and drug companies are encouraged to use more."

He added that advertising often spurs patients to demand certain drugs or procedures, and that experts estimate that 30 percent of treatments are wasteful.

With the help of the lists, doctors and patients should start conversations with each other, Santa said.

The initiative began when Howard Brody, the director of the Institute for the Medical Humanities at the University of Texas Medical Branch at Galveston, wrote a 2010 editorial in The New England Journal of Medicine that said doctors were partly responsible for rising costs.

He proposed that every medical specialty name five common procedures that are expensive and lack benefits.

Today, he said he was encouraged by what he saw.

"It's a challenge for doctors to look in the mirror and say, 'Maybe not everything was good,' " he said. "It's a first important step, but now their behavior has to change."

Otherwise, Brody said, insurance companies might stop paying for those treatments rather than letting physicians make the decisions. In those cases, exceptions wouldn't be considered.

"If a physician sits on his hands, that's crazy. If doctors don't take the leadership, somebody else will do it. And that's not as good for the patient," Brody said.

For future reports, the campaign has the financial support of a $2.5 million grant from the Robert Wood Johnson Foundation.

"Now we want to drive things down to local communities," Wolfson said.

For more information on all 90 recommendations, go to www.choosingwisely.org/doctor-patient-lists/

Explore further: Physician groups call for fewer medical tests

Related Stories

Physician groups call for fewer medical tests

April 4, 2012
(HealthDay) -- Nine physician specialty groups have created lists of common tests or procedures that they believe are often overused or unnecessary, to help doctors and patients make wiser decisions about care.

New effort by MDs to cut wasteful medical spending

April 4, 2012
(AP) -- Old checklist for doctors: order that test, write that prescription. New checklist for doctors: first ask yourself if the patient really needs it.

Doctors recommend different treatments for patients than for themselves

April 11, 2011
(PhysOrg.com) -- The act of making a recommendation appears to change the way physicians think regarding medical choices, and they often make different choices for themselves than what they recommend to patients, according ...

Kidney society describes ways to eliminate wasteful tests and procedures

September 13, 2012
Earlier this year, the American Society of Nephrology (ASN), the world's leading kidney organization, joined other groups in a campaign to help health care professionals and patients avoid wasteful and sometimes harmful medical ...

ACR in Choosing Wisely campaign to promote wise use of resources among physicians and patients

December 14, 2011
As part of its ongoing efforts to ensure safe, effective and appropriate medical imaging, the American College of Radiology has joined the ABIM Foundation and eight other medical specialty societies in Choosing Wisely. The ...

Recommended for you

Brain disease seen in most football players in large report

July 25, 2017
Research on 202 former football players found evidence of a brain disease linked to repeated head blows in nearly all of them, from athletes in the National Football League, college and even high school.

Safety of medical devices not often evaluated by sex, age, or race

July 25, 2017
Researchers at Yale and the University of California-San Francisco have found that few medical devices are analyzed to consider the influence of their users' sex, age, or race on safety and effectiveness.

Why you should consider more than looks when choosing a fitness tracker

July 25, 2017
A UNSW study of five popular physical activity monitors, including Fitbit and Jawbone models, has found their accuracy differs with the speed of activity, and where they are worn.

Dog walking could be key to ensuring activity in later life

July 24, 2017
A new study has shown that regularly walking a dog boosts levels of physical activity in older people, especially during the winter.

Alcohol to claim 63,000 lives over next five years, experts warn

July 24, 2017
Alcohol consumption will cause 63,000 deaths in England over the next five years – the equivalent of 35 deaths a day – according to a new report from the University of Sheffield Alcohol Research Group.

Alcohol boosts recall of earlier learning

July 24, 2017
Drinking alcohol improves memory for information learned before the drinking episode began, new research suggests.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.