(Some) Docs Launch War on Overutilization

(Reuters)–A leading group of U.S. doctors is trying to tackle the costly problem of excessive medical testing, hoping to avoid more government intervention in how they practice.

The American College of Physicians (ACP), the largest U.S. medical specialty group, is rolling out guidelines to help doctors better identify when patients should screen for specific diseases and when they can be spared the cost, and potentially invasive procedures that follow.

(Reuters)–A leading group of U.S. doctors is trying to tackle the costly problem of excessive medical testing, hoping to avoid more government intervention in how they practice.

The American College of Physicians (ACP), the largest U.S. medical specialty group, is rolling out guidelines to help doctors better identify when patients should screen for specific diseases and when they can be spared the cost, and potentially invasive procedures that follow.

Many individual U.S. medical centers have launched their own efforts to build a protocol of patient care in fields such as diabetes or obstetrics, but the ACP effort has the potential to influence doctors nationally. ACP members include more than 132,000 physicians, mainly focused on internal medicine.

“Excessive testing costs $200 billion to $250 billion (per year),” Dr. Steven Weinberger, CEO of ACP said in an interview from his office in Philadelphia. “There’s an overuse of imaging studies, CT scans for lung disease, overuse of routine electrocardiograms and other cardiac tests such as stress testing.”

In an article published last month in the Annals of Internal Medicine, the ACP cited 37 clinical situations where screening did not promote health and might actually hurt patients.

They included performing coronary angiography – a procedure that uses a special contrast agent and X-rays to see inside the heart’s arteries – in patients with chronic, stable chest pain that is being controlled by drugs or who lack specific high-risk criteria on exercise testing.

“It’s medical gluttony,” said Dr. Otis Brawley, chief medical officer of the American Cancer Society.

“The ironic thing is that people are talking about rationing. We have got to think about the rational use of medicine in order to avoid rationing medicine,” he said.

For Weinberger, establishing guidelines on when to perform a range of diagnostic tests in order to cut waste out of the healthcare system is one of his top priorities at ACP.

He should enjoy broad-based support, as U.S. healthcare costs reached $2.6 trillion in 2010, contributing to a spiraling national deficit. That’s $8,086 per person, or 17.6 percent of the nation’s gross domestic product, government figures show.

Yet there certainly will be protests from some doctors who decry guidelines as undermining their judgment and the art of practicing medicine. Guidelines may also cut into their income. (To read more, click here.)