I must say, I’m very proud of the American Academy of Family Physicians for continuing to make statements about over-testing under the Choosing Wisely campaign umbrella. The Academy is more known for making wussy statements and taking wussy actions — the RUC wimp out being the prime example. So I salute my brethren and sistren for growing a spine and clearly stating actions physicians should not take. Here is the list:
- Don’t schedule elective, non-medically indicated inductions of labor or Cesarean deliveries before 39 weeks, 0 days gestational age.
- Avoid elective, non-medically indicated inductions of labor between 39 weeks, 0 days and 41 weeks, 0 days unless the cervix is deemed favorable
- Comment: Wow! The Academy is actually making pronouncements about C-sections and maternity care in general. Could this mean family physicians actually perform C-sections? Why of course they do!!
- Don’t screen for carotid artery stenosis (CAS) in asymptomatic adult patients.
- Comment: This means please ignore the personal testimonies appearing in your local media from people who claimed that “simple” screening procedures saved their lives when they purchased the $200 ultrasound package.
- Don’t screen women older than 65 years of age for cervical cancer who have had adequate prior screening and are not otherwise at high risk for cervical cancer.
- Don’t screen women younger than 30 years of age for cervical cancer with HPV testing, alone or in combination with cytology.
- Comment: Could this mean the Academy’s frequent statements about the value of family medicine lies in screening and prevention is showing a chink in the armor? Fabulous!!
Way to go AAFP!!