ACP members weigh in on minimal, low value treatments physicians engage in

By Liz Meszaros, MDLinx
Published December 19, 2016

Key Takeaways

The most frequently used treatment interventions provided by physicians that may be of minimal or low value include antibiotic overuse, treatment of chronic pain, provision of dietary supplements, and aggressive non-palliative treatment of patients with limited life expectancy, according to results from a study based on a random survey conducted by the American College of Physicians (ACP) in 5,000 ACP member physicians. Results were published in the latest issue of the journal Annals of Internal Medicine.

“While many current clinical guidelines recommend appropriate care, the results of this survey may reflect intrinsic motivations to err on the side of treatment rather than ‘doing nothing,’” said lead author Amir Qaseem, MD, FACP, PhD, Vice President, Clinical Policy, ACP, and Chair of ACP’s High Value Care Task Force. “However, as health care shifts to a value-driven system, this study shows that doctors are willing to critically assess their own clinical practice.”

These member physicians completed a survey in which they were asked to list two treatments frequently used by internists but not likely to provide “high-value care” for patients.

The ACP recently developed High Value Care recommendations to help clinicians as well as patients understand the benefits, risks, and costs of various treatment options so that they could collaborate better on deciding which treatments may improve patient health, prevent harm, and eliminate wasteful practices.

Included in these recommendations is advice on the following:

  • Prescribing antibiotics for acute respiratory tract infection in adults,
  • Breast cancer screening,
  • Cardiac screening,
  • Cervical cancer screening,
  • Colorectal cancer screening,
  • Ovarian cancer screen,
  • Prostate cancer screening,
  • End-of-life communications,
  • Upper endoscopy for gastroesophageal reflux,
  • Generic medications,
  • Inpatient glycemic control,
  • Hematuria, and
  • Evaluation for suspected pulmonary embolism.

Further analysis of responses to the ACP survey also revealed that physicians continue to prescribe costly treatments, regardless of data that show generic medications are both efficacious and efficient and a lack of data that show that newer, more costly agents are superior to older medications.

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