Quote:
Nine medical societies, including the American Society of Clinical Oncology and the American College of Cardiology, representing nearly 375,000 physicians are challenging the widely held perception that more health care is better, releasing lists Wednesday of tests and treatments their members should no longer automatically order.
The 45 items listed include most repeat colonoscopies within 10 years of a first such test, early imaging for most back pain, brain scans for patients who fainted but didn't have seizures, and antibiotics for mild- to-moderate sinus distress.
Also on the list: heart imaging stress tests for patients without coronary symptoms. And a particularly sobering recommendation calls for cancer doctors to stop treating tumors in end-stage patients who have not responded to multiple therapies and are ineligible for experimental treatments.
The 45 items listed include most repeat colonoscopies within 10 years of a first such test, early imaging for most back pain, brain scans for patients who fainted but didn't have seizures, and antibiotics for mild- to-moderate sinus distress.
Also on the list: heart imaging stress tests for patients without coronary symptoms. And a particularly sobering recommendation calls for cancer doctors to stop treating tumors in end-stage patients who have not responded to multiple therapies and are ineligible for experimental treatments.
Such voluntary rationing is expected to help eliminate waste within the system. The guidelines do get specific - when studies have shown certain treatments to be effective or have evidence that a test prevents or helps diagnose the illness further, the recommendation is to go forward still.
The problem apparently is an entitled attitude among Americans with insurance: I have insurance, therefore I deserve to have this test paid for, and it will help me sleep at night even if it doesn't show anything further wrong with me. And doctors have been complicit, which means giving antibiotics for viral sinus infections because patients insist on it, or ordering invasive biopsies for things that turn out to not be cancer at all. (I remember when my mother had a lumpectomy on a breast, and it tuned out to be a clogged pore. And any dermatologist would have known that, but because she went to an oncologist, they panicked.)