Last year, the American Board of Internal Medicine Foundation and Consumer Reports teamed up to launch the "Choosing Wisely" campaign. Each of the 39 medical specialty societies has, within its arena, identified five specific medical screening or treatment procedures which are probably unnecessary under particular circumstances, but might be recommended by a physician eager to minimize personal liability and/or make more money from each patient.

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2. Last year, the American Board of Internal Medicine Foundation and
Consumer Reports teamed up to launch the "Choosing Wisely" campaign.
Each of the 39 medical specialty societies has, within its arena, identified
five specific medical screening or treatment procedures which are
probably unnecessary under particular circumstances, but might be
recommended by a physician eager to minimize personal liability and/or
make more money from each patient.
www.hrp.net
»
The project also includes a set of articles on
common medical situations or decision points
which can help employees choose the right path.
»

3. Promoting Conversation
The purpose of Choosing Wisely is "to
promote conversations between
patients and physicians about tests
which may be ineffective, unnecessary
or needlessly risky," according to a
Consumer Reports website
enumerating "Consumer Health
Choices."
»
www.hrp.net
The physicians behind the effort are just as concerned about unnecessary
procedures and tests as those who pay for them. One reason is many
procedures and tests carry medical risks which may not be worth the
benefit of the diagnostic screening or medical procedure in question.
Also, most patients themselves, whether they have financial skin in the
game (as most do) or not, are not hypochondriacs with an unlimited
appetite for visits to the doctor.
»

4. Promoting Conversation
The only apparent tie-in to the Affordable Care Act (ACA) is that
employers offering health benefits obliged to expand the scope of
medical services to satisfy "minimum essential benefits" standards
(including preventive medicine) may experience a surge in employee
utilization of services, some necessary, others not.
»
www.hrp.net
Here are examples of advice which came out of the Choosing Wisely
campaign, with regard to some common tests and procedures from
various medical specialty organizations. Each statement below can be
found on this webpage along with an explanation, plus research citations
to support the findings.
»

5. American Academy of Family Physicians:
• Don't do imaging for low back pain within the first six weeks, unless
red flags are present.
• Don't order EKGs or any other cardiac screening for low-risk patients
without symptoms.
• Don't screen women younger than 30 for cervical cancer with HPV
testing, alone or in combination with cytology.
• Don't screen for carotid artery stenosis in asymptomatic adult
patients.
www.hrp.net
American Academy of Pediatrics:
• Antibiotics should not be used for apparent viral respiratory illnesses
(sinusitis, pharyngitis, bronchitis).
• Cough and cold medicines should not be prescribed or recommended
for respiratory illnesses in children under four years of age.
• CT scans are not necessary in the routine evaluation of abdominal
pain or the immediate evaluation of minor head injuries.

6. American College of Obstetricians and Gynecologists
• Don't schedule elective, non-medically indicated inductions of labor
or Cesarean deliveries before 39 weeks 0 days gestational age.
• Don't perform routine annual Pap tests in women 30-65 years of age.
• Don't screen for ovarian cancer in asymptomatic women at average
risk.
www.hrp.net
American College of Cardiology
• Don't perform stress cardiac imaging or advanced non-invasive
imaging in the initial evaluation of patients without cardiac symptoms
unless high-risk markers are present.
• Don't perform annual stress cardiac imaging or advanced non-invasive
imaging as part of routine follow-up in asymptomatic patients.
• Don't perform echocardiography as routine follow-up for mild,
asymptomatic native valve disease with no change in signs or
symptoms.

7. American Academy of Neurology:
• Don't perform electroencephalography (EEG) for headaches.
• Don't use opioid or butalbital treatment for migraine except as a last
resort.
• Don't perform imaging of the carotid arteries for simple syncope
without neurologic symptoms.
www.hrp.net
American Academy of Ophthalmology
• Don't perform preoperative medical tests for eye surgery unless there
are specific medical indications.
• Don't routinely order imaging tests for patients without symptoms or
signs of significant eye disease.
• Don't order antibiotics for adenoviral conjunctivitis (a variety of "pink
eye" caused by a particular virus).

8. The Consumer Reports "Consumer Health Choices" website contains sets
of free articles on tests and treatments, drugs and supplements, doctors,
hospitals and even a set of prices (including a national range as well as
national and local "fair" prices) for procedures ranging from brain MRIs to
vasectomies as well as cosmetic procedures, such as breast
augmentation/reduction.
www.hrp.net
»
As the old saying goes, you can lead a horse to water, but you can't make
it drink. Fortunately, employees are not horses. Leading them to
independent information on medical and health topics will cause at least
some of them to think twice about blindly following their doctors'
instructions, or taking matters entirely into their own hands with possible
disastrous results.
»

9. 14550 Torrey Chase Blvd., Ste. 360 Houston, TX 77014 USA
www.hrp.net
E-mail : info@hrp.net
Toll Free
Phone
Fax
:
:
:
877.880.4477
281.880.6525
281.866.9426

10. 14550 Torrey Chase Blvd., Ste. 360 Houston, TX 77014 USA
www.hrp.net
E-mail : info@hrp.net
Toll Free
Phone
Fax
:
:
:
877.880.4477
281.880.6525
281.866.9426