The ABIM foundation asked all the major medical and surgical specialty societies in the US to each submit “Five Things Physicians and Patients Should Question“. The specialty societies picked five tests or procedures they thought were being overused or wasteful. Each one of the “things” is an important well researched piece of advice the societies believe health care providers and patients should know. Who is doing the questioning is not clear — but it seems if providers are not following the advice then other doctors, quality assurance departments and patients themselves should ask questions.
The assortment of ABIM documents is mainly intended for physicians so they do contain technical terms. Fortunately, the ABIM partnered with Consumer Reports to write FREE consumer friendly versions of the ABIM recommendations. The site has a nice navigation bar so you can quickly find helpful information. Here is a link to the site: Consumer Health Choices.
The author of this blog created an abridged version for a quick scan of everything to date. Take your choice, either the original, the Consumer Reports version or the abridged (no beating around the bush) version. A few societies have not yet submitted information so check back with the ABIM Foundation site later if interested.
There seem to be some common threads in the advice:
- Don’t do tests if there is no plan to act on the tests (or to find a disease that has no treatment)
- Don’t do screening tests if testing errors cause unnecessary or harmful surgery or other tests.
- The time interval for screening tests is very important (especially for cost reasons)
- Imaging (nuclear scans, CT, MRI, PET, ultrasound etc.) has been massively overused — always question whether imaging is needed.
- In general, don’t fix things that don’t eventually cause symptoms
The advice is both favorable for patients and favorable to reduce the cost of health care. The US needs more of these evidence-based guidelines.