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Image 72 of Lexington Herald-Leader, October 21, 2012

Part of Lexington Herald-Leader

OCTOBER 21, 2012 ADVERTISING SUPPLEMENT TO THE LEXINGTON HERALD-LEADER 15 LESS MEDICINE SOMETIMES THE BEST MEDICINE B BY JOHN A. PATTERSON, M.D. oth physicians and patients share some essential common goals of good medicine: using appropriate tests to determine a correct diagnosis, using appropriate treatment for the diagnosed condition, avoiding harm caused by testing and treatment — and doing all this as economically as possible. Physicians and patients have both embraced modern diagnostic technology and modern medical treatments, in part because they have helped relieve tremendous suffering and saved countless lives. But unsustainable cost increases and inevitable, tragic harm done to patients have both led several major medical organizations to consider ways for medicine to be practiced even more wisely, humanely, safely and economically. The “Choosing Wisely” campaign includes medical tests and treatments that are not only unnecessary under certain conditions, but can also cause serious harm. An important consideration in this Choosing Wisely initiative is testing that is itself considered safe, but that can lead to further testing with increasing potential for harm. Nine medical organizations initiated the Choosing Wisely campaign: American Academy of Allergy, Asthma and Immunology; Ameri- can Academy of Family Physicians; American College of Cardiology; American College of Physicians; American College of Radiology; American Gastroenterological Association; American Society of Clinical Oncology; American Society of Nephrology; and American Society of Nuclear Cardiology. Other medical organizations are in the process of adding their specialty’s contribution. The initial scientific paper announcing the Choosing Wisely campaign appeared as part of the “Less is More” series in the Archives of Internal Medicine, one of the family of scholarly medical journals published by the American Medical Association. With the Choosing Wisely campaign, these medical groups seek to increase public health and decrease patient harm by educating both physicians and consumers about overused diagnostic and therapeutic interventions. For adults, the initial list includes: 1. X-ray, CAT scan, MRI for low back pain. 2. Antibiotics for sinus infections. 3. Routine annual EKG and other cardiac screening. 4. Pap smears. 5. DEXA (BMD) scans to screen for osteoporosis. 6. Screening healthy adults with routine blood or urine testing. 7. Statins to initiate therapy to lower cholesterol or triglycerides. In children, these include: 1. Antibiotics for sore throat/tonsillitis. 2. X-ray, CAT scan, MRI after minor head injury. 3. Specialty consultation for middle ear infections. 4. Use of cough and cold medication. 5. Steroid (cortisone) inhalers in asthma. Frank conversations about these interventions can help patients and their physicians avoid causing harm, contain health care costs and make rational decisions based on medical evidence of safety and effectiveness. Consumer Reports Health is partnering with these medical societies to make this information available to the public. You can find out more at Choosingwisely.org or Consumerhealthchoices.org/campaigns/ choosing-wisely.

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