Top 5 don’ts for doctors in primary care

6/13/2011

Antibiotics for sore throats and CT scans for minor head injuries in children are among the most wasteful practices in primary care medicine, a national physicians’ group said. Among the others are electrocardiograms performed routinely on healthy adults and widespread prescribing of brand-name statins to reduce LDL, or “bad” cholesterol.

The group issuing the report, the National Physicians Alliance, an organization of 22,000 physicians, developed three separate “Top Five” lists for primary care doctors — internists, family doctors, and pediatricians — that were essentially lists of medical “don’ts.” The lists were published online in The Archives of Internal Medicine.

The authors urged doctors not to perform bone-density scans on women younger than 65 and men younger than 70 who have no risk factors for osteoporosis. The researchers also urged physicians to forgo basic blood screening in healthy adults (though screening for cholesterol was recommended, as was diabetes screening in some cases).

“Doctors are inundated with ‘do this’ and ‘do that.’ We wanted to focus on what doctors should not do,” said Stephen Smith, professor emeritus of family medicine at the Warren Alpert Medical School at Brown University in Providence, who led the initiative.

“We wanted to come up with the top things that primary care physicians can do that would enhance quality, but also reflect the idea of being good stewards of finite medical resources, save money, and reduce harms and risks.”