The American Board of Internal Medicine Foundation recently led an initiative to reduce unnecessary testing. It’s called the ChooseWisely campaign and can be reached at http://www.choosingwisely.org/
There were nine medical societies that participated. Some of you might have seen articles in NEJM and the Annals of Internal Medicine where people proposed 5 tests that should have reduced usage. Examples included EKGs at annual physicals and routine cardiac testing for patients with stable anginal symptoms. (For that matter, the physical exam part of an annual physical is essentially useless. Maybe they’ll address this reality in their next set of recommendations.)
While I’m totally in support of this effort, it also reminds me that for some of these recommendations there are no good randomized controlled trials to tell us if they’re beneficial or not. The American healthcare system needs a lot more attitude of “when in doubt, don’t.” However, it would be nice if the NIH funded trials to help all of us learn which tests actually lead to better outcomes. Unfortunately, the NIH funds research in miracles not efficiency.
Happy Easter everyone.