No matter your personal views on the controversial Affordable Care Act, there’s one aspect of the country’s healthcare system that most of us can agree on: healthcare is incredibly expensive.
A routine office visit costs $11 in Spain, $30 in France and $30 in Canada. In the United States, that cost can skyrocket up to $176, according to an annual report released by the International Federation of Health Plan (IFHP), a worldwide insurance trade organization.
A hip replacement costs $9,574 in Switzerland, $11,187 in the Netherlands and $11,889 in the United Kingdom. In the United States, a hip replacement costs up to $87,987.
Whatever the reason(s) for this massive cost disparity, it doesn’t appear to be deterring people from receiving often unnecessary screenings and treatments.
In an effort to cut down on the amount of needless health care procedures, the American Board of Internal Medicine (ABIM) created Choosing Wisely, a campaign that enables different medical societies to create lists of “Things Physicians and Patients Should Question.”
Overall, more than 50 different medical organizations have submitted their lists of potentially unnecessary (yet often suggested) procedures, including a few you may recognize:
Antibiotics for sinus infections: Doctors indiscriminately prescribing antibiotics to patients with mild sinus infections (sinusitis) is often pointed to as a huge contributor to the rise of antibiotic-resistant illnesses. Indeed, antibiotics are prescribed 80 percent of the time for acute sinusitis, despite the fact that many of these infections are caused by viruses, not bacteria. The American Academy of Family Physicians (AAFP) counsels doctors to avoid prescribing antibiotics to those whose sinus infections last less than a week and who aren’t experiencing classic symptoms, such as a face that is tender to the touch, or nasal discharge that is discolored.
Prostate cancer exams: Regular cancer screenings are almost universally upheld by medical experts as invaluable tools for identifying cancer in its earliest stages so that it can be treated as soon as possible. However in certain cases, these tests may do more harm than good, especially with regards to prostate-specific antigen tests for detecting prostate cancer. There is much debate surrounding whether “Physicians should not offer or order PSA screening unless they are prepared to engage in shared decision-making that enables an informed choice by patients,” says the AAFP.
Cardiac stress tests: Unless an individual has factors that make them more prone to developing heart disease (i.e. high cholesterol, hypertension, obesity, etc.), having them undergo a cardiac stress test may be unnecessary. In fact, 45 percent of needless screenings are performed on individuals exhibiting now symptoms of heart disease, and who have only a minor risk of developing cardiac concerns, according to the AAFP. They recommend testing only those with more than a two percent annual risk for having a coronary heart disease event, people over 40 years old who also have diabetes, and those with peripheral artery disease (PAD).
Scoliosis testing: Unless an adolescent is exhibiting back pain or other signs of severe scoliosis, there is no reason to screen them for abnormal spine curvature, according to the AAFP. Unnecessary tests have the potential to generate false positives that could cause unnecessary follow-up tests and treatments for a minor problem.
The main point Choosing Wisely is meant to drive home is that patients and doctors need to be more open and honest when discussing treatment options. Patients need to be informed of all the potential benefits and drawbacks of tests and procedures; and they need to feel comfortable having a candid dialogue with their doctor.
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