Choosing Wisely Campaign Aims To Cut Use of Unnecessary Medical Interventions

Sometimes, less health care is the best health care.

As part of an effort to help physicians curtail the practice of ordering unnecessary tests and procedures, the AAFP today released a list of five tests and treatments physicians should think twice about before performing, ordering or prescribing. The list is part of a national campaign called Choosing Wisely that launched at a press event here. The campaign is working to identify specific tests or procedures commonly used within various specialties that are not always necessary.

The Academy's involvement in the Choosing Wisely campaign underscores family physicians' long-term commitment to ensuring high-quality, cost-effective care to patients, said AAFP President Glen Stream, M.D., M.B.I., of Spokane, Wash., in a prepared statement.

"Family medicine's 'top 5' list encourages more in-depth conversations between patients and their doctors so they discuss all options and then 'choose wisely' when it comes to a treatment plan," he said.

According to the Congressional Budget Office, as much as 30 percent of care provided in the United States consists of unnecessary tests, procedures, medical appointments, hospital stays and other services that may not improve people's health. CMS projects that if U.S. health care spending continues at current levels, it will reach $4.3 trillion, or 19.3 percent of the nation's gross domestic product, by 2019.

In response, the Academy and eight other medical specialty societies -- the American Academy of Allergy, Asthma and Immunology; the American College of Cardiology; the American College of Physicians; the American College of Radiology; the American Gastroenterological Association; the American Society of Clinical Oncology; the American Society of Nephrology; and the American Society of Nuclear Cardiology -- joined the Choosing Wisely campaign, which originated as an initiative of the American Board of Internal Medicine Foundation, last year.

The nine organizations initially participating in the Choosing Wisely campaign worked individually and collaboratively to create evidence-based lists of overused tests and treatments for their individual specialties. Dubbed "Five Things Physicians and Patients Should Question," the lists are designed to help physicians and patients think and talk about overuse or misuse of health care resources.

The AAFP's list consists of the following five recommendations:

The lists drawn up by the campaign's eight other medical specialty partners are available on the Choosing Wisely website. In addition, eight more medical specialty organizations signed on to the campaign during today's press event. They are scheduled to release their lists this fall.

In an interview after the press event, Stream stressed the need to develop a solid, secure physician-patient relationship so meaningful patient conversations can take place.

"People really do need a doctor who knows them and can help them navigate the medical system if they have a serious medical problem," he told AAFP News Now. "It is also important to note that it is one thing to get a 'Choosing Wisely' decision from a doctor who knows you, but that to do that, you have to build trust up over time.

"I think that as family physicians, our role is unique, because we are not only managing the care that we give, but it is also just as critical that we coordinate care for our patients using our subspecialty colleagues."