(May 24, 2011 - Insidermedicine)

When it comes to some aspects of patient care, it appears that less is more, according to research published in the Archives of Internal Medicine. A group of primary care physicians has determined that patients are frequently better served when their doctors refrain from ordering certain tests or prescribing certain medications in specific situations.
 
Here are some ways to have a successful visit with your doctor:

•    Write down any questions before you go, and also write down the answers

•    Don’t insist on antibiotics to treat a cold or flu

•    If tests are ordered, ask what they are for and how the results may affect your care

Members of the National Physicians Alliance formed The Good Stewardship Working Group with the aim to develop a list of activities in family medicine, internal medicine, and pediatrics that could improve patient care. Ideally, these activities would relate to common scenarios seen in primary care, would be strongly supported by medical evidence and, if followed, would lead to significant health benefits and reduce harms, risks, and costs. Once the Working Group developed a list of these activities, they field tested them with over 200 physicians, narrowing them down to twelve key activities that were strongly supported by their field testers.

Almost all of the twelve activities involved refraining from doing something. For instance, in the area of family medicine, key recommendations included refraining ordering imaging tests for lower back pain, prescribing antibiotics for sinusitis, or screening for osteoporosis in patients under 65 unless certain specific factors were present that suggested such tests or treatments were warranted. Similarly, in the area of internal medicine, recommendations included avoiding unnecessary bloodwork or cardiac testing, and in the area of pediatrics, recommendations included avoiding inappropriate use of antibiotics and staying away from cough medicines altogether.

Today’s research suggests that when physicians don’t do something – such as order tests they do not think are necessary or prescribe antibiotics for a cold – they are likely doing you a favor.