Choosing Wisely

Posted June 28, 2017

Health care insurance helps cover the cost of a lot of important needs — our primary provider services, specialist services, medications, preventive screenings, hospital care and special tests when we’re sick. Question is, how do we know which medical tests or treatments are truly appropriate?

For example, do you think you need an MRI for your knee or back pain? Do you need that antibiotic for a skin infection? Or an electrocardiogram (ECG) with your annual exam? Do you even need an annual exam? As you know, tests and procedures are costly. In some cases, they’re unnecessary or harmful.

As patients, how can we better understand and use our health care? In seeking answers, the American Board of Internal Medicine Foundation launched the Choosing Wisely national educational campaign in 2012. The goal is threefold:

• Improve communication between patients and their health care providers.

• Identify the most beneficial services during illness or wellness.

• Help control unnecessary and wasteful use of health care services.

Choosing Wisely efforts are teaching patients and providers to recognize that health does not always improve with more care. Even if a test or treatment has been shown to benefit some, using it as a universal standard may not be appropriate for all.

The U.S. spends more than $2.8 trillion on health care each year, and some estimate that 30% of that price tag may be for duplicated and unnecessary services.

Many of America’s leading medical societies are participating in the Choosing Wisely campaign. It now includes more than 70 national groups representing physicians and other health care professionals, patients and employers (the primary sponsors of health care in the U.S.). The program has identified many tests and procedures that have low value to many patients.

Watch List:

Following are some of the services that providers and patients should question as not necessarily beneficial. This is a partial list developed and supported by multiple medical societies representing family medicine, oncology, OB-GYN and others.

• Pap smears for women before age 21, or for those who have had a hysterectomy for a non-cancer disease.

• Annual ECGs or any other cardiac screening for low-risk patients without symptoms.

• Bone density screening for osteoporosis in women before age 65 or men before age 70 with no risk factors.

• Breast MRI for breast cancer screening in average-risk women.

• Imaging for low-back pain within the first 6 weeks of pain, unless red flags are present.

• Antibiotics for acute mild-to-moderate sinusitis unless symptoms last 7 or more days or worsen after initial improvement.

• Routine blood work, other than to test a CEA level during surveillance for colorectal cancer.

Discussing the health care services listed above with your provider will help you make the best choices possible — for saving your health and health care dollars.

The goal of quality health care: Get the right care at the right time for the best results.

Learn more at Choosing Wisely.

— Diane McReynolds