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Utahns warned: Unneeded medical tests do more harm than good

Published March 24, 2014 10:03 pm

Choosing Wisely effort wants patients to be aware of unnecessary tests and treatments.
This is an archived article that was published on sltrib.com in 2014, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

When your son is doubled over with stomach pain, you take him to the hospital, which is exactly what Alan Ormsby did two years ago with his then-10-year-old.

"His symptoms pointed to it being a bad case of constipation, but to be sure, we ordered an X-ray to rule out something more serious like appendicitis," he said. The scan came back clear, but the doctor insisted upon also ordering a more thorough CT scan.

Three hours and $400 later, Ormsby left the hospital with assurance that what ailed his son could be fixed with a $2.99 laxative.

"When the doctor is in there in front of your kid saying, 'We gotta do this,' it's kind of intimidating and hard to question that authority," he said.

But that's exactly what Ormsby, director of AARP Utah, is encouraging health consumers to do as part of a national Choosing Wisely campaign coming to Utah.

An initiative promoted by the American Board of Internal Medicine, the campaign seeks to raise awareness of five common procedures and tests that are unnecessary, provide little value and can pose risks to patients.

Among them are imaging tests for low back pain within the first six weeks of symptoms, antibiotics for viral head and chest colds and some CT scans.

About 50 percent of children who visit hospital emergency departments with a head injury are given a CT scan, when observing children for signs of concussion is often more effective and less expensive, says Choosing Wisely, citing the American Academy of Pediatrics.

What's more, CT scans expose children to unnecessary ionizing radiation, actually raising their lifetime risk of cancer.

HealthInsight, a nonprofit organizing the local campaign, is holding panel discussions and town halls in coming weeks.

They're encouraging health consumers to ask the following questions of their doctor before a procedure:

• Do I really need this test or procedure?

• What are the risks?

• Are there simpler, safer options?

• What happens if I don't do anything?

• How much does it cost?

Greater public awareness is only part of the solution; doctors need to take ownership of the problem, too, acknowledges Wayne Cannon, medical director of the Primary Care Clinical program at Intermountain Healthcare.

But patients are a critical piece of the equation, he explained.

"Single doctors might see two or three patients who have a bad reaction [to a certain treatment standard] and that prejudices them against it, but if you show them data on how they compare with peers, they get it," he said.

"The big thing is doctors are so pressed for time and they want to deliver patient satisfaction," Cannon said. "There's always that patient who says, 'My neighbor got this procedure' or 'My wife got an antibiotic and I need one, too.' Sometimes it's just easier for a doctor to send the patient home with an antibiotic."

kstewart@sltrib.com

Twitter: @KStewart4Trib —

Save the date

Salt Lake City

Choosing Wisely panel discussion on Thursday, March 27, from 4 p.m. to 5:30 p.m. at the University of Utah's Hinckley Institute of Politics (Orson Spencer Hall, 260 S. South Campus Dr., room 253.)

Orem

Town hall discussion on reducing waste and improving health care on Monday, April 7, noon to 1 p.m. at Utah Valley University's Sorensen Student Center, Ragan Theater (800 W. University Parkway).

Both events are free and open to the public. For more information about the local Choosing Wisely campaign, visit http://www.healthinsight.org/choose.