Nearly three out of four U.S. physicians say the frequency with which doctors order unnecessary medical tests and procedures is a serious problem for America’s health care system—but just as many say that the average physician orders unnecessary medical tests and procedures at least once a week, according to research released today by the ABIM Foundation.
Funded by the Robert Wood Johnson Foundation (RWJF), the survey looks at physician attitudes regarding the overuse of medical services in the United States, and shows that more than half of physicians think they are in the best position to address the problem and have ultimate responsibility for making sure patients avoid unnecessary care. Yet at the same time, more than half the physicians surveyed say they’d give an insistent patient a medical test they knew to be unnecessary.
The survey comes two years after the launch of Choosing Wisely, a ground-breaking effort to encourage physicians and patients to think and talk about whether certain medical tests and procedures are really necessary for their condition. Since April 2012, 60 medical specialty societies have joined the campaign and identified more than 250 tests and procedures they say are overused or inappropriate. The effort has attracted significant attention in medical journals and the consumer press.
One in five physicians (21%) surveyed say they are aware of the Choosing Wisely campaign. Of those, 62 percent say they are more likely to have reduced the number of times they recommended a test or procedure because they learned it was unnecessary; this compares to 45 percent for those who are unaware of the effort.
“Old habits are hard to break, but this research suggests that America’s physicians are slowly making progress in efforts to reduce unnecessary care,” said Richard J. Baron, MD, president and CEO of the ABIM Foundation. “Avoiding unnecessary medical care is important because care that is not needed can be harmful to patients, and unnecessary care raises health care costs for everyone. Physicians and patients both play roles in reducing the overuse of medical care in America, and this research suggests Choosing Wisely is making a difference.”
Survey findings include:
- 73 percent of physicians say the frequency of unnecessary tests and procedures is a very or somewhat serious problem.
- 66 percent of physicians feel they have a great deal of responsibility to make sure their patients avoid unnecessary tests and procedures.
- 53 percent of physicians say that even if they know a medical test is unnecessary, they order it if a patient insists.
- 58 percent of physicians say they are in the best position to address the problem, with the government as a distant second (15%).
- 72 percent of physicians say the average medical doctor prescribes an unnecessary test or procedure at least once a week.
- 47 percent of physicians say their patients ask for an unnecessary test or procedure at least once a week.
- 70 percent of physicians say that after they speak with a patient about why a test or procedure is unnecessary, the patient often avoids it.
The phone survey of 600 physicians nationwide was conducted February 12 through March 21, 2014 by PerryUndem Research/Communication. The margin of sampling error is: ± 4.0 percentage points.
The research is part of RWJF’s commitment to improving the quality and value of care that all Americans receive. Last year, RWJF funded grants to 21 medical societies, regional health organizations and consumer advocates to educate physicians and patients about Choosing Wisely recommendations.
“It is a promising sign that an increasing number of physicians are accepting responsibility for reducing unnecessary medical care delivered in the United States,” said John R. Lumpkin, MD, RWJF senior vice president. “Conversations between doctors and patients about what care really is and isn’t necessary have always been hard. Only by shedding light on these issues, and being transparent about which tests and procedures might not be needed, will we help create a sustainable culture of health in America.”
New Choosing Wisely Partners Announced
Recognizing that all health care providers play a critical role in the delivery of care, the ABIM Foundation also announced today that the Choosing Wisely campaign will expand to include non-physician provider organizations. Later this year, the American Dental Association, American Physical Therapy Association and the American Academy of Nursing will release lists of medical tests and procedures that are commonly used in their profession, but whose use should be questioned. Consumer Reports will also work with each organization to develop patient-friendly materials based on their lists.