Health Care Spending On Unnecessary Tests Discouraged By Major Medical Groups

Put Down The X-Ray Machine And Back Away

WASHINGTON -- With health care costs growing out of control, medical societies made up of family physicians, cardiologists and other specialists have a message for America's doctors: Don't be so quick to order expensive procedures like CT scans and X-rays. Unnecessary tests and treatments pad the nation's health care bill and expose patients to needless risks, the groups say.

On Wednesday, nine doctors' organizations -- including the American College of Physicians, the American Academy of Family Physicians and the American College of Cardiology -- along with business and consumer groups are launching an effort to reduce unnecessary medical tests and treatments, thereby saving costs and cutting back on patients' exposure to stressful and sometimes dangerous procedures.

The "Choosing Wisely" campaign is the latest push by groups representing American doctors to rein in wasteful spending that arises out of physicians' assessments of what constitutes best practices for patients. The nine doctors' groups emphasize that patients don't always need high-tech testing, at least not as a first resort.

Waste in the U.S. health care system is estimated to be as high as $850 billion a year, according to a 2009 Thomson Reuters report. For example, 44 percent of people between ages 40 and 60 told Consumer Reports in 2010 that they had received heart-disease screenings like electrocardiograms or "stress tests" despite having no symptoms and not being considered at risk for heart disease.

The American Board of Internal Medicine Foundation organized the campaign, which is also supported by the Service Employees International Union, the National Partnership for Women & Families, AARP, Wikipedia, Consumer Reports, and the National Business Group on Health and other organizations representing employers that provide health benefits to their workers.

The organizations identify 45 tests or procedures about which doctors and patients should think twice. "Physicians, working together with patients, can help ensure the right care is delivered at the right time for the right patients," said Christine Cassel, president and CEO of the American Board of Internal Medicine Foundation, in a news release.

Electronic tests like MRIs for lower-back pain, routine CT scans of the brain and chest X-rays, and cardiac stress tests for patients with no symptoms should be avoided unless the physician and patient determine there's a specific reason for the procedure, according to the guidelines. The groups also advise against routinely prescribing antibiotics for sinus infections, giving high doses of drugs to treat heartburn and other gastrointestinal disorders, and ordering Pap smears for women who are younger than 21 years old or have had a hysterectomy.

The American College of Physicians triggered a minor controversy earlier this year when it unveiled its own, separate set of guidelines. The organization named 37 tests that are overused and encouraged doctors to avoid them for patients without specific symptoms or risks of disease. Critics charged that the organization was encouraging the rationing of medical services because the American College of Physicians described its approach as "parsimonious care."

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