04:24pm Friday 15 November 2019

Medical societies identify tests and treatments physicians prescribe too often

ANN ARBOR, Mich. Leading medical societies have identified specific tests, procedures or medication therapies they say are commonly ordered, but which are potentially unnecessary – and sometimes harmful. Each of 17 medical societies participating in the second phase of the Choosing Wisely campaign identified five specific tests or procedures within their specialty that physicians and patients should question. University of Michigan Cardiovascular Center cardiologist and president-elect of the Society for Vascular Medicine James Froehlich, M.D., M.P.H., had a hand in creating and presenting the list of five things patients and doctors should question within vascular medicine at a joint press conference Feb. 21. The new list from the SVM includes recommendations such as avoiding pre-operative stress testing for patients undergoing low-risk surgery, and skipping clotting disorder lab tests for patients who suffer a first episode of deep vein thrombosis (DVT)when there’s already a clear clause.

DVTs are blood clots known to develop among hospitalized patients who are immobilized. Otherwise healthy people who have had limited movement for a long period of time, such as travelers on long flights and car, bus or train rides who do not walk around regularly, are also at-risk for vein clots. “Lab tests to look for a clotting disorder will not alter treatment of a venous blood clot, even if an abnormality is found, in this setting,” says Froehlich, a specialist in circulation conditions. “DVT is a common disorder, and recent discoveries of clotting abnormalities have led to increased testing without proven benefit.” As part of the ABIM’s Choosing Wisely campaign more than 130 tests and procedures have so far been identified as ones patients should question.The campaign is sponsored in collaboration with Consumer Reports, which hopes to spark conversations between patients and physicians about what care is really necessary. “Twenty-five of the nation’s leading medical specialty societies have now spoken up and shown leadership by identifying what tests and treatments are common to their profession, but are not always beneficial,” Christine K. Cassel, M.D., president and CEO of the ABIM Foundation, said in a news release. “Millions of Americans are increasingly realizing that when it comes to health care, more is not necessarily better. Through these lists of tests and procedures, we hope to encourage conversations between physicians and patients about what care they truly need.” All of the recommendations were developed by the individual specialty societies after months of careful consideration and review. Using the most current evidence about management and treatment options within their specialty, the societies believe the recommendations can have a significant impact on patient care, safety and quality. The 25 specialty societies that have now released lists are undertaking considerable efforts to share the recommendations with their collective membership of more than 725,000 physicians. The campaign is also reaching millions of consumers nationwide through a stable of consumer and advocacy partners, including Consumer Reports. The complete lists from the specialty societies, available at www.ChoosingWisely.org, include additional detail about the recommendations and evidence supporting them.


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