Nine physician organizations have teamed up to identify specific tests or procedures commonly, but not always practically, used in their respective fields.
The American Board of Internal Medicine Foundation has brought together the American Academy of Family Physicians (AAFP), the American College of Physicians, the American College of Cardiology, the American College of Nuclear Cardiology, the American Academy of Allergy, Asthma & Immunology, the American Gastroenterological Association, the American Society of Clinical Oncology, the American College of Radiology, and the American Society of Nephrology. Each group has posted a list of “Five things Physicians and Patients Should Question,” on the Choosing Wisely website.
For example, the five “don’ts” specified by the AAFP are:
- Don’t do imaging for low back pain within the first six weeks unless red flags are present
- Don’t routinely prescribe antibiotics for acute mild-to-moderate sinusitis unless symptoms last for seven or more days or symptoms worsen after initial clinical improvemen
- Don’t use DEXA screening for osteoporosis in women younger than age 65 years or in men younger than age 70 years with no risk factor
- Don’t order annual ECGs or any other cardiac screening for low-risk patients without symptoms
- Don’t perform Pap smears on women who are younger than age 21 years or who have had a hysterectomy for noncancer disease
Each organization included additional details to explain when a particular test or treatment may be appropriate.