Physicians Ask Patients to Question Unnecessary Medical Tests

April 5, 2012

Medical testing, and the effort to stop physicians from doing too much of it, is ramping up among regulators, insurers, and physician groups.

Practice-based physicians will need to make a better effort not to order tests for patients that aren’t truly medically necessary.  

That’s because medical testing, and the effort to stop physicians from doing too much of it, is ramping up among regulators, insurers, and physician groups.

Most notably, nine physician organizations representing 374,000 physicians this week launched a new “Choosing Wisely” campaign to bring to light some of most common tests ordered by physicians that are often medically unnecessary, financially overused, and potentially dangerous to patients.

As part of the campaign, each participating organization came up with a list of “Five Things Physicians and Patients Should Question” to build consumer awareness to the importance of physician and patient conversations.  Each list represents specific, evidence-based recommendations, according to American Board of Internal Medicine (ABIM) Foundation, the blanket organization overseeing the campaign.

In the list created by the American Academy of Family Physicians, for example, the number one recommendation is “Don’t do imaging for low back pain within the first six weeks, unless red flags are present.”

That this effort comes on the heels of last week’s Supreme Court hearings of the Affordable Care Act - a law, which, at its core, centers on necessary healthcare spending - is merely a coincidence, said Daniel Wolfson, executive VP and COO of ABIM.

“The timing with the Supreme Court [hearings] is fortuitous,” Wolfson told Physicians Practice. “We’ve been in discussion with the specialty societies about joining the campaign for one year. There is a general problem of overuse, and ordering tests and procedures that aren’t necessary in most cases.”

Over-ordering tests happens for many reasons, even among the most well-meaning physicians, Wolfson said. For starters, it’s habit. “That’s the way we’ve always done it, and it’s difficult to change habits,” he said.

In addition, “there’s a lot of consumer research going on, and consumers are coming in with a lot of requests, and there’s a tendency [by physicians] to order more tests to cover all bases.”

Still, Wolfson conceded, many physicians might be wondering, “Why would someone want to reduce their income by reducing test procedures?” There are two answers for that. 

“One is that the world is changing, and we’re seeing it through the healthcare initiatives,” said Wolfson. “Accountable care organizations and Patient-centered Medical Homes are all changing the notion of what will be rewarded in the marketplace. I believe the marketplace will reward appropriate care and better outcomes.”

Second, if the healthcare law stays intact, “34 million people will have access to better insurance, and a there will be increased needs, and we need to free up capacity to address those needs.”

Interestingly, a recent, unrelated study published in the journal Health Affairs cites a 40 percent to 70 percent increase in testing among doctors with computerized access to test results (sometimes, but not necessarily, through an EHR).