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What not to do: Nine doc groups ID 45 'unnecessary' procedures

ABIM Foundation, Consumer Reports effort aims to reduce medical waste

Topics: Appropriateness, Quality, Performance Improvement, Process Improvement, Efficiency, Screening and Prevention, Methodologies, Cost Management, Margin Performance, Finance

April 04, 2012

In a rare, coordinated effort to reduce medical waste, nine physician specialty organizations each have identified five tests and procedures in their respective fields that may be unnecessary or overused.

The 45 tests and procedures were identified as part of the American Board of Internal Medicine (ABIM) Foundation's Choosing Wisely campaign, a multiyear initiative that aims to reduce the use of unnecessary medicine and increase dialogue between patients and physicians.

"Overuse is one of the most serious crises in American medicine," said Lawrence Smith, physician-in-chief at North Shore-LIJ Health System. "Many people have thought that the organizations most resistant to this idea would be the specialty organizations, so this is a very powerful message."

The participating physician groups—which represent nearly 375,000 physicians nationwide—are the:

  • American Academy of Allergy, Asthma & Immunology;
  • American Academy of Family Physicians;
  • American College of Cardiology (ACC);
  • American College of Physicians;
  • American College of Radiology (ACR);
  • American Gastroenterological Association;
  • American Society of Clinical Oncology;
  • American Society of Nephrology; and
  • American Society of Nuclear Cardiology.

Breaking down the lists
Each list provides evidence-based recommendations to help physicians and patients make wise care decisions on an individualized basis. For example, the lists detail when particular procedures may be inappropriate:

  • ACC recommends against annual stress cardiac imaging during routine follow-up exams for asymptomatic patients;
  • ACR recommends against imaging for uncomplicated headaches; and
  • AGA recommends against repeat colorectal cancer screenings in average-risk patients within 10 years of a negative result.

"These societies have shown tremendous leadership in starting a long overdue and important conversation between physicians and patients about what care is really needed," says ABIM Foundation President and CEO Christine Cassel.

Eight additional specialty groups are expected to release similar lists later this year.

Consumer Reports rallies support behind campaign
Consumer Reports has partnered with the ABIM Foundation to spearhead the Choosing Wisely campaign.

On Wednesday, the group announced that 11 consumer-focused organizations—including AARP, the Leapfrog Group, and the National Partnership for Women & Families—also will join the campaign to spread information and educate patients on medical decision making. According to a news release, each of the groups could reach one million or more U.S. consumers (ABIM Foundation release, 4/4; Hellmich, USA Today, 4/4; Caryn Rabin, New York Times, 4/4; Shelton/Deardorff, Chicago Tribune, 4/4; Choosing Wisely factsheets, 4/4).

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