Key questions proposed for physician-patient discussions

Nine healthcare societies in conjunction with the ABIM Foundation’s Choosing Wisely campaign have identified 45 medical tests and procedures that are commonly used but not always necessary in their respective practice areas.

The lists, released April 4, present the ““Five Things Physicians and Patients Should Question” in each of nine practice and specialty areas with the intent of providing specific, evidence-based recommendations of things patients and doctors should discuss in order to make appropriate healthcare decisions.

The following nine organizations, representing nearly 375,000 physicians, released the lists:

  • American Academy of Allergy, Asthma & Immunology
  • American Academy of Family Physicians
  • American College of Cardiology
  • American College of Physicians
  • American College of Radiology
  • American Gastroenterological Association
  • American Society of Clinical Oncology
  • American Society of Nephrology
  • American Society of Nuclear Cardiology


“These societies have shown tremendous leadership in starting a long overdue and important conversation between physicians and patients about what care is really needed,” said Christine K. Cassel, MD, president and CEO of the ABIM Foundation, a non-profit foundation of the American Board of Internal Medicine, in a press release. “Physicians, working together with patients, can help ensure the right care is delivered at the right time for the right patient. We hope the lists released today kick off important conversations between patients and their physicians to help them choose wisely about their healthcare.”

Here’s a sampling of questions patients should explore with their doctors:

  • Do patients need brain imaging scans like a computed tomography (CT) or magnetic resonance imaging (MRI) after fainting, also known as simple syncope?
  • Do patients need stress tests for annual checkups?
  • Should patients going into outpatient surgery receive a chest X-ray beforehand?
  • Do patients need a CT scan or antibiotics for chronic sinusitis?
  • Should dialysis patients who have limited life expectancies and no signs or symptoms of cancer get routine cancer screening tests?
  • Should women under 65 or men under 70 be screened for osteoporosis with dual energy X-ray absorptiometry (DEXA)?

The complete lists from the specialty societies include additional detail and evidentiary information that includes when a particular test or treatment may be appropriate based on clinical evidence and guidelines.

Consumer Reports, which has collaborated with the ABIM Foundation on the effort, will work with 11 consumer-oriented organizations, with a potential reach of more than 1 million consumers to help educate them and disseminate the information about the 45 procedures.

In 2010, Consumer Reports conducted a survey of 1,200 healthy 40 to 60 years olds with no known heart disease or other risk factors, which showed that 44 percent of them had received screening tests for heart disease that the magazine said were very unlikely or unlikely to have benefits that outweighed the risk of the tests themselves.

“By identifying tests and procedures that might warrant additional conversations between doctors and patients, we are able to help patients receive better care through easy-to-use and accessible information,” said James A. Guest, JD, president and CEO of Consumer Reports, in a prepared statement. “We’re looking forward to being a part of this innovative effort working with the ABIM Foundation, the specialty societies and our eleven consumer communications collaborators to get this important message out to diverse populations of patients.”

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