The Society of General Internal Medicine (SGIM) has released a list of specific tests or procedures that are commonly ordered but not always necessary in general internal medicine as part of the Choosing Wisely® campaign, an initiative of the ABIM Foundation. The list identifies five targeted, evidence-based recommendations that can support conversations between patients and physicians about what care is really necessary.
“SGIM is delighted to support the Choosing Wisely campaign,” said SGIM president Eric B. Bass, MD, MPH from Johns Hopkins University School of Medicine. “We believe that general internists have an important role to play in helping patients make informed decisions about tests and procedures that may otherwise be used too often.”
SGIM’s list identified the following five recommendations:
- Don’t recommend daily home finger glucose testing in patients with Type 2 diabetes mellitus not using insulin.
- Don’t perform routine general health checks for asymptomatic adults.
- Don’t perform routine pre-operative testing before low-risk surgical procedures.
- Don’t recommend cancer screening in adults with life expectancy of less than 10 years.
- Don’t place, or leave in place, peripherally inserted central catheters for patient or provider convenience.
“Physicians in General Internal Medicine have a special long-term relationship with their patients. Our goal is to maintain our patients’ health and function, to treat their acute and chronic diseases, and to coordinate care with other specialties on behalf of our patients. The Choosing Wisely topics seek to identify areas where we can engage our patients in conversations designed to enhance their health across this spectrum of practice. We are proud to engage in this specialty-defined Choosing Wisely effort to enhance care on behalf of our patients,” said Laurence F. McMahon, MD, MPH (University of Michigan Medical Center), chair of the SGIM ad hoc Choosing Wisely committee.
The SGIM Choosing Wisely list was developed after months of careful consideration and review, using the most current evidence about management and treatment options. An ad hoc committee of SGIM was impaneled taking advantage of the clinical expertise of members from the existing Clinical Practice and the Evidence-Based Medicine Committees within the Society. Members of the ad hoc committee were then solicited to determine possible topics for consideration. The topics chosen were selected to meet the goals of the Choosing Wisely campaign, taking advantage of the unique clinical perspective of members of the Society in ambulatory General Medicine as well as hospital-based practice. The final topics were selected by a vote of committee members based on the strength of the existing evidence, the unique standing members of the Society have in addressing the clinical topics selected, as well as contributions the recommendations would make in terms of patient safety, quality, and economic impact. The final recommendations were approved by the governing Council of SGIM.
“SGIM has shown tremendous leadership by releasing its list of tests and procedures they say are commonly done in general internal medicine, but aren’t always necessary,” said Richard J. Baron, MD, president and CEO of the ABIM Foundation. “The content of this list and all of the others developed through this effort are helping physicians and patients across the country engage in conversations about what care they need, and what we can do to reduce waste and overuse in our health care system.”
To date, more than 80 national and state medical specialty societies, regional health collaboratives and consumer partners have joined Choosing Wisely to advance conversations about appropriate care. With the release of more than 30 new lists in late 2013 and early 2014, the campaign will have covered more than 250 tests and procedures that the specialty society partners say are overused and inappropriate, and that physicians and patients should discuss.
The campaign also continues to reach millions of consumers nationwide through a stable of consumer and advocacy partners, led by Consumer Reports—the world’s largest independent product-testing organization—which has worked with the ABIM Foundation to distribute patient-friendly resources for consumers and physicians to engage in these important conversations.