The checklist for doctors is changing to 45 recommended tests. It comes from nine medical societies representing nearly 375,000 physicians. They are challenging the widely held perception that more health care is better.
The list of items include repeat colonoscopies within 10 years of a first test, early imaging for most back pain, brain scans for patients who fainted but didn’t have seizures and antibiotics for mild to moderate sinus distress.
Also on the list: heart imaging stress tests for patients without coronary symptoms. And a particularly sobering recommendation calls for cancer doctors to stop treating tumors in end-stage patients who have not responded to multiple therapies and are ineligible for experimental treatments.
Dr. Christine Cassel, president of the American Board of Internal Medicine, said the goal is to reduce wasteful spending without harming patients. She suggested some may benefit by avoiding known risks associated with medical tests, such as exposure to radiation.
“We all know there is overuse and waste in the system, so let’s have the doctors take responsibility for that and look at the things that are overused,” she said. “We’re doing this because we think we don’t need to ration health care if we get rid of waste.”
Cassel’s group sets standards and oversees board certification for many medical specialties.
The recommendations come at a time when American health care is undergoing far-reaching changes. No matter what the Supreme Court decides on President Barack Obama’s health care overhaul, employers, lawmakers, insurers and many doctors are questioning how the U.S. spends far more on medical care than any other economically advanced country and still produces mediocre results overall.
Until now, the health care system has rewarded doctors for volume. Now the focus is shifting to paying for results and coordination. This means that doctors will choose carefully to identify areas of questionable spending.
Could this mean cheaper health care? Doubt it, but then again, it’s unclear how much money would be saved if doctors followed the 45 recommendations rigorously.