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Over-treatment remains a problem

Written by Diane Archer

A new JAMA Internal Medicine study reveals that over-treatment remains a problem, even though doctors know that some of the care they provide and tests they order are unnecessary. This unneeded care both drives up health care costs and can put patients at risk.  You should beware of unnecessary care.

The researchers for this study looked at seven recommendations from the Choosing Wisely campaign–which works with doctors to identify and reduce the use of medical tests and treatments that have small clinical benefit–to see whether doctors were heeding their own advice.

The researchers found a reduction in use for two out of seven health care services with low value.  People with simple headaches are getting fewer imaging services, including MRIs and CAT scans, from 14.9 percent to 13.4 percent. And cardiac imagining for people without heart conditions also fell from 10.8 percent to 9.7 percent.

But, the researchers also found an increase in use for two other health care services with low value. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) for people with hypertension, heart failure, or chronic kidney disease grew from 14.4 percent to 16.2 percent. And, human papillomavirus testing for women under 30 also grew from 4.8 percent to 6 percent.

Overall, the researchers found only small changes in physician behavior. They recommend interventions to reduce use of these low value services beyond the Choosing Wisely campaign. To avoid getting unnecessary care, check out the advice on the Choosing Wisely site.

The Choosing Wisely campaign brings together doctors from more than 70 specialty societies in order to call out unnecessary procedures and limit overuse.  And, they have a list of more than 400 treatments and tests that should not be given without first discussing their risks as well as their benefits.



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