Some will consider the announcement a turning point – a watershed event – in health care. Nine medical societies representing nearly 375,000 physicians joined forces to challenge the widely held perception that more health care is automatically better.

The medical groups that participated are: American Academy of Allergy, Asthma & Immunology, American Academy of Family Physicians, American College of Cardiology, American College of Physicians, American College of Radiology, American Gastroenterological Association, American Society of Clinical Oncology, American Society of Nephrology and American Society of Nuclear Cardiology.

Last Wednesday they released lists of tests and treatments their members should no longer order automatically. Key to the recommendations is that word “automatically.”

The 45 items listed – five from each of the organizations – included most repeat colonoscopies within 10 years of a first such test, early imaging for most back pain, brain scans for patients who fainted but didn’t have seizures and antibiotics for mild-to-moderate sinus distress.

Also on the list: Heart imaging stress tests for patients without coronary symptoms. A particularly sobering recommendation calls for cancer doctors to stop treating tumors in end-stage patients who have not responded to multiple therapies and are ineligible for experimental treatments.

Dr. Christine Cassel, president of the American Board of Internal Medicine, told the Associated Press the goal is to reduce wasteful spending without harming patients. She suggested some patients might actually benefit from the recommendations by avoiding known risks associated with medical tests, such as exposure to radiation.

“We all know there is overuse and waste in the system, so let’s have the doctors take responsibility for that and look at the things that are overused,” said Cassel. “We’re doing this because we think we don’t need to ration health care if we get rid of waste.” Her group sets standards and oversees board certification for many medical specialties.

Dr. James Fasules of the American College of Cardiology said the goal is to begin changing attitudes among patients and doctors.

“We kind of have a general feeling that if you don’t get a test, you haven’t been cared for well,” said Fasules. “That has permeated American culture now.”

The new advice isn’t meant to override a doctor’s judgment, Fasules added, but to inform and support decisions.

Eight other medical societies are developing additional recommendations.

The medical societies don’t have any power of enforcement, and fear of malpractice lawsuits – as much a part of the American culture as the notion that testing is the benchmark of good medical care – may well prompt many doctors to keep ordering as many tests as ever.

Unfortunately, that fear of malpractice may negate the positive efforts of the various medical societies.

...