The right care at the right time is the goal of a national initiative to reduce the use of unnecessary and ineffective medical treatments.
The Choosing Wisely® program is a joint effort of Consumer Reports, the American Board of Internal Medicine Foundation and 70 other national medical boards. Locally, Sharp Rees-Stealy Medical Group is the only group in Southern California participating in Choosing Wisely.
Sharp Rees-Stealy is targeting five tests and treatments shown to be overused or ineffective:
- Prescribing antibiotics for adults with bronchitis
- Diagnostic testing for lower-back pain
- Preoperative stress testing
- Imaging for uncomplicated headaches
- Repetitive complete-blood count and chemistry testing
In addition to these five areas, the Choosing Wisely program offers patients advice on everything from allergy tests — when patients need them and when they don’t — to vision care for children. The advice comes in the form of short, easy-to-understand handouts, which are available in English and Spanish.
Sharp Rees-Stealy’s Dr. Parag Agnihotri, Continuum of Care Medical Director, says in the case of antibiotics for bronchitis, they may do more harm than good.
“Ninety percent of bronchitis cases are caused by viruses. Antibiotics don’t work on viruses. Yet, many patients want their doctor to do something when they aren’t feeling well or are in pain. But over-prescribing antibiotics actually reduces their effectiveness. Our goal is to educate both patients and doctors on providing the right, high-quality care at the right time,” says Dr. Agnihotri.
Back pain is one of the most common reasons people visit the doctor. Many patients ask their doctor to prescribe imaging tests such as X-rays, CT scans or MRIs to find out what’s causing their pain. But these tests usually don’t help. Most people with lower-back pain will feel better in about a month whether or not they have an imaging test. Lower-back pain typically goes away when patients follow simple steps such as walking or taking over-the-counter medications.
Beyond being ineffective, there are several downsides to getting an unneeded imaging test. The tests do have some risk such as exposure to radiation in an X-ray. A false positive can cause stress and lead to unnecessary treatments — even surgery — and they’re expensive.
“The Choosing Wisely materials provide important background to patients and doctors, alike. We encourage everyone to read them and use them as starting points for a good conversation between patient and physician,” says Dr. Agnihotri. “At Sharp Rees-Stealy, we have committed to reducing unnecessary tests and treatments in our five key categories by at least 20 percent.”