Doctors do stuff — tests, procedures, drug regimens, and operations. It’s what they’re trained to do, what they’re paid to do and often what they fear not doing.
So it’s pretty significant that a broad array of medical specialty groups is issuing an expanding list of don’ts for physicians.
Don’t induce labor or perform a cesarean section for a baby who’s less than full-term unless there’s a valid medical reason, say the American College of Obstetrics and Gynecology and the American Academy of Family Physicians. (It can increase the risk of learning disabilities and respiratory problems.)
Don’t automatically do a CT scan on a child with a minor head injury, warns the American Academy of Pediatrics. (Currently half of all such children get them, when simple observation is just as good and spares radiation risk.)
Don’t try to normalize blood sugar in most diabetic patients over 65, exhorts the American Geriatrics Society. (It can lead to higher mortality rates.)
And on and on. The latest list totals 90 tests and procedures that are often unnecessary and potentially harmful, compiled by 17 specialty groups representing more than 350,000 doctors.
The list is the second chapter in a campaign called Choosing Wisely sponsored by the Foundation of the American Board of Internal Medicine. Last year the foundation warned against 45 tests, procedures and treatments that often do patients no good. That list was endorsed by nine medical specialty organizations.
The new don’ts bring the total to 135.
The idea is to curb unnecessary, wasteful and often harmful care, its sponsors say — not to ration care. As one foundation official pointed out last year, rationing is denial of care that patients need, while the Choosing Wisely campaign aims to reduce care that has no value.