17 medical specialty organizations have come up with their top five tests or procedures that they feel are unnecessary or harmful to patients. For example, women younger than 21 and those who have had a hysterectomy for any reason other than cancer should not get Pap smears at all. This is a change from 2008 when I was in school, when we were taught that a sexually active woman younger than 21 years should have a pap smear every year for three years. If these were all normal, then it could be done every other year.
In Sharon Begley’s article, “Just say don’t: Doctors question routine tests and treatments,” she states that “For the most part, the medical specialty groups did not consider cost when they made their lists”. She quotes Dr. John Santa, director of Consumer Reports’ Health Ratings Center and a partner in Choosing Wisely as saying, “If their advice is followed, however, it would save billions of dollars a year in wasteful spending.” He calculated that in a practice with 300,000 patients, just doing away with routine EKGs and bone density scans would “reduce it’s billings by $1 million a year.” If done nationally, “that translates into some $1 billion in savings.”http://www.reuters.com/article/2013/02/21/healthcare-tests-choosingwisely-correcte-idUSL1N0BL3EB20130221
Of course, less spending does translate into less revenue for the healthcare practitioner. A woman coming in every three years for her Pap means that my clinic will lose the revenue for the two she doesn’t get.
There’s always the question of, “What if I miss something because I followed these recommendations?” Ah….well, we are given the option in some cases of ordering a test if we suspect something unusual. Note that some procedures are questioned while some start with the word “don’t.”
For a complete list of organizations that gave their top fives, follow this link: