Leave Well Enough Alone

May 26, 2011

Ordering fewer tests and prescribing fewer antibiotics will not only curb health care spending but also improve the quality of primary care, says the National Physicians Alliance (NPA).  The group's report, published in the Archives of Internal Medicine, follows concerns over the growing use of new technologies, such as CT scans, that in many cases don't have a clear medical value.  The report lists five evidence-based recommendations in three areas: family medicine, internal medicine and pediatrics, says Reuters.

The gist of the advice?  Leave well enough alone.

  • For instance, the group discourages the use of blood and urine tests in healthy people, because they will probably yield few results and end up costing a lot.
  • It also cautions against heart tests such as ECGs or CT scans in symptom-free, low-risk individuals, because there is scant evidence that spotting cholesterol buildups provides any benefit in these people.
  • The NPA also recommends against imaging tests for lower back pain in the first six months, noting that such tests do not lead to better results.

For kids, the group urges doctors to hold off on antibiotics for a sore throat, unless the strep test comes back positive.  Most sore throats are caused by viruses, which don't respond to antibiotics, and using the drugs unnecessarily may fuel the spread of drug-resistant bacteria and expose patients to side effects, says Reuters.

Source: "Doctors Prescribe Fewer Tests for Better Care," Reuters, May 23, 2011.  "The 'Top 5' Lists in Primary Care," Archives of Internal Medicine, May 23, 2011.

For text:

http://www.reuters.com/article/2011/05/23/us-doctors-tests-idUSTRE74M6JI20110523

For study:

http://archinte.ama-assn.org/cgi/content/short/archinternmed.2011.231

 

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