NCPA - National Center for Policy Analysis

Physicians Wade into Efforts to Curb Unnecessary Treatments

April 11, 2012

A new campaign called "Choosing Wisely" has been initiated by nine prominent physician groups with a single, broad-based message: more treatment is not always better.  Attempting to curb the use of unnecessary treatments that raise costs and often harm patients, the group released lists of 45 common tests and treatments they say should be reduced in use, says Kaiser Health News.

The energy for the campaign comes largely from a broad push to reduce national health care expenditures by creating a sleeker, more cost-efficient system.

  • Unnecessary treatment has been estimated to account for as much as a third of the $2.6 trillion Americans spend on health care each year.
  • One obstacle to reducing such spending is that the decision to prescribe treatment is usually in the hands of the physician -- the party that benefits financially from additional action.

The physician groups in question, many of which face potential financial losses if their guidance is followed, represent a diverse sample of the health field: family physicians, cancer doctors, cardiologists, radiologists, gastroenterologists, allergists and kidney specialists.

Furthermore, the treatments targeted for greater scrutiny are largely uncontroversial, avoiding hot-button issues such as prostate-specific antigen testing and mammograms.  Rather, the authors of the list focused on treatments that can truly be labeled superfluous without substantial debate:

  • Routine electrocardiograms for patients at low risk for heart disease.
  • Antibiotics for mild sinus infections.
  • X-rays or other scans for uncomplicated headaches or early evaluation of low back pain.
  • Exercise electrocardiograms, often called "stress tests" or "treadmill tests," for low-risk patients with no symptoms of heart disease.
  • Chemotherapy for patients with advanced solid-tumor cancers who are unlikely to benefit.

The physician groups emphasize that unnecessary treatments can lead to additional radiation exposure, side effects from medications or unneeded surgeries.  This augments the mandate for greater scrutiny of treatment decisions.

Source: Julie Appleby, "Physicians Wade into Efforts to Curb Unnecessary Treatments," Kaiser Health News, April 4, 2012.

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