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San Francisco Marin Medical Society Blog

Physician Group Coalition Expands List of Overused Tests, Treatments in Choosing Wisely Campaign



17 medical specialty societies have added their names and recommendations to a list of overused tests and procedures that should be avoided.

The updated list—which includes 90 new items—was released today that includes tests and procedures that participating societies consider possibly unnecessary or harmful.

The project, known as “Choose Wisely,” is being spearheaded by the American Board of Internal Medicine (ABIM) with the hope that the list will encourage patients and physicians to follow evidence-based guidelines in managing health problems, while avoiding procedures that could cause more harm than good.

While the campaign itself won’t measure any cost reductions achieved, there are billions in savings to be had by eliminating waste. The U.S. spends an estimated $2.5 trillion a year on health care, or more than $8,000 per person—far more than in other developed countries. Much of that money is wasted. The U.S. health care system squandered about $750 billion a year as of 2009, or more than a third of total health care expenditures, according to a report released last year by the Institute of Medicine. That included some $210 billion in excess costs due to unnecessary services.

The new recommendations include:

  • Waiting 6 weeks to do imaging for low back pain, unless red flags are present.
  • Avoiding elective, non-medically indicated inductions of labor between 39 weeks and 41 weeks.
  • Not requiring annual pap tests in women ages 30 to 65.
  • Steering clear of ordering antibiotics for adenoviral conjunctivitis.
  • Not ordering continuous telemetry monitoring outside of the ICU without using a protocol that governs continuation.

The full list of questionable tests and procedures is available at ChoosingWisely.org.

ABIM hopes to release a third list later this year that will include 13 more societies, including the American Academy of Dermatology and the American Academy of Orthopaedic Surgeons. 

Click here to download the full list of Five Things Physicians and Patients Should Question (for physicians).

Click here to read about how the Choosing Wisely Campaign was launched from ABIM Board Chair, Catherine Lucey, MD



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