A number of doctors' groups have come together to create a list of 45 medical tests or procedures they say are commonly used, but often unnecessary.


They say the list is intended to start a discussion between doctors and patients, with the ultimate goal of improving patient care and reducing waste of health care resources.


All together, nine physician groups contributed to the list, with each group naming five tests that the members felt doctors should question.


The over-used procedures included:


  • Computed tomography (CT) or magnetic resonance imaging (MRI) scans for people who have fainted but have no other neurological symptoms, according to the American College of Physicians
  • Bone density scans to screen for osteoporosis in women under 65 and men under 70 with no risk factors for the disease, according to the American Academy of Family Physicians (AAFP)
  • Imaging tests for patients with lower back pain within the first six weeks of their symptoms, unless "red flags" are present such as severe neurological deficits, according to the AAFP.
  • Pap smears for women under age 21, according to AAFP, because most abnormalities in adolescents go away on their own
  • Imaging tests on people with run-of-the-mill headaches, according to the American College of Radiology
  • Cardiac stress imaging tests for otherwise healthy adults without cardiac symptoms, according to the American College of Cardiology (the tests should be performed only on patients at risk for heart disease, those with diabetes over 40 years old, and those with peripheral arterial disease)
  • Antibiotics for people with uncomplicated sinus infections, because most resolve without treatment within a few weeks, according to the American Academy of Allergy, Asthma & Immunology (viruses cause the majority of sinus infections, and antibiotics won't help in these cases)
  • Another colonoscopy within 10 years, for most patients age 50 or older who have one negative colonoscopy, according to the American Gastroenterological Association
  • Routine cancer screening tests for patients on dialysis with limited life expectancies and no signs or symptoms of cancer, according to the American Society of Nephrology (these tests do not improve survival in thesepatients, and can lead to over treatment and unnecessary stress)

The nine individual lists, called Five Things Physicians and Patients Should Question, were put together by the American Board of Internal Medicine (ABIM) Foundation.


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