Choosing wisely
The family physicians in de Family Practice the Stethoscope in Weesp are strong supporters of Choosing Wisely. Choosing wisely is an initative of a great number of medical organisations in de US. The aim is – to put it simple – to be more costeffective in the medical industry. We all: patiënts, doctors and insurancecompagnies, are responsable for the costs of healthcare. Doctor Burggraaff is a member of the American Academy of Family Physicians, a partnerorganisation of Choosing Wisely. A consumerhealthorganisation is also a strong advocate of Choosing Wisely. Check their website!
Are you curious for more info? Check the Choosing Wisely Master List. For a complete list you click here.
Patients can use a 5 step aproach together with their healthcareprovider to choose wisely. Those 5 steps are:
- Do I really need this?
- What are the downsides?
- Are there simpler, safer options?
- What happens if I do nothing?
- How much does it cost?
The 2014 recommendations you can find here. And to be happy and know what choosing wisely is all about look here.
The 2013 recommandations (9-27-2013) are:
- “Do not prescribe antibiotics for otitis media in children aged 2-12 years with non-severe symptoms where the observation option is reasonable.” The “observation option” is the ability to defer antibacterial treatment of selected children for 48 to 72 hours, limiting management to symptomatic relief.
- “Do not perform voiding cystourethrogram…routinely in first febrile urinary tract infection…in children aged 2-24 months.” Risks associated with radiation (plus the discomfort and expense of the procedure) outweigh the risk of delay.
- “Do not routinely screen for prostate cancer using a prostate-specific antigen (PSA) test or digital rectal exam.” Evidence suggests that PSA-based screening leads to substantial overdiagnosis of prostate tumors.
- “Do not screen adolescents for scoliosis.” Potential harms include unnecessary follow-up visits and evaluations resulting from false-positive test results and psychological adverse effects.
- “Do not require a pelvic exam or other physical exam to prescribe oral contraceptive medications. Hormonal contraceptives are safe, effective, and well tolerated for most women.“The previously by the American Academy of Family Physicians released Choosing Wisely recommendations are:
- “Don’t schedule elective, non-medically indicated inductions of labor or Cesarean deliveries before 39 weeks, 0 days gestational age.
- Avoid elective, non-medically indicated inductions of labor between 39 weeks, 0 days and 41 weeks, 0 days unless the cervix is deemed favorable.
- Don’t screen for carotid artery stenosis in asymptomatic adult patients.
- Don’t screen women older than 65 years of age for cervical cancer who have had adequate prior screening and are not otherwise at high risk for cervical cancer.
- Don’t screen women younger than 30 years of age for cervical cancer with HPV testing, alone or in combination with cytology.
- Don’t do imaging for low back pain within the first six weeks, unless red flags are present.
- Don’t routinely prescribe antibiotics for acute mild-to-moderate sinusitis unless symptoms last for seven or more days OR symptoms worsen after initial clinical improvement.
- Don’t use dual-energy X-ray absorptiometry…screening for osteoporosis in women under age 65 or men under 70 with no risk factors.
- Don’t order annual electrocardiograms or any other cardiac screening for low-risk patients without symptoms.
- Don’t perform Pap smears on women under the age of 21 or women who have had a hysterectomy for non-cancer disease.”
© H.B. Burggraaff, verloskundige huisarts Waarschapsstraat 1a 1382 EG Weesp