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Choosing Wisely

Consumer Reports is working with doctors to help patients avoid unnecessary and potentially harmful medical care

Published: February 2013

Doctors often order tests and recommend treatments when they shouldn’t—sometimes even when they know they shouldn’t. In fact, nearly half of primary-care physicians say their own patients get too much medical care, according to a survey conducted by researchers at Dartmouth College. And the Congressional Budget Office says that up to 30 percent of the health care in the U.S. is unnecessary.

The problem has become so serious that the ABIM Foundation, together with more than 20 professional medical societies, have joined forces in a project called Choosing Wisely in which each group identifies five tests or treatments that they themselves say are done too often. (Read more about the Choosing Wisely campaign.)

Consumer Reports is also participating in the effort, by helping the medical societies produce videos (above) and PDFs that doctors can share with patients about specific overused tests and treatments. Some of those PDFs are shown below. (See a complete list of the reports, including some in Spanish and Easy Read versions.) In addition, we are also writing about the issue of unnecessary and overused medical care in our own publications. Some of those stories are also shown below.

Consumer Reports' articles

Best health care often costs less
Cancer tests you need—and those you don't
Cancer treatments you may not need
How to avoid unnecessary medical care
Is it an allergy or sinusitis?
'Low-T': Don't fall for the hype
Should you be tested for Alzheimer's
What to reject when you're expecting
When to say 'Whoa!' to your doctor

Choosing Wisely reports

Allergies, asthma, and respiratory diseases

Allergies: IgG replacement therapy (AAAAI)
Allergies: When are tests necessary? (AAAAI)
Asthma: Spirometry testing (AAAAI)
Respiratory infections in children: When are antibiotics necessary? (AAP)
Sinusitis: Antibiotics (AAAAI)
Sinusitis: Antibiotics (AAFP)

Alzheimer's disease

When is testing necessary (SNMMI)
When are feeding tubes necessary? (AGS, AAHPM)

Cancer

Breast cancer: Imaging tests (ASCO)
Cervical cancer: Pap smears (AAFP)
Chemotherapy: Drugs to prevent infection (ASCO)
Colon cancer: Colonoscopy (AGA)
End of life care (ASCO)
Hard decisions (ASCO)
Prostate cancer: Imaging tests (ACR)

Heart disease

Echocardiograms for valve disease (ACC)
EKGs and stress tests (AAFP)
Heart disease and pain relievers (ASN)
Imaging tests for heart disease (ACC)
Imaging tests for chest pain (ASNC)
Imaging tests after bypass surgery or angioplasty (ASNC)
Imaging tests after heart surgery (ACC)
Treating peripheral artery disease (SVM)

Pre-surgery tests

Chest X-rays before surgery (ACR)
Echocardiogram before surgery (ASE)
Imaging tests before surgery (ACC)
Imaging tests before surgery (ASNC)
Lab tests before surgery (ASCP)
Medical tests before eye surgery (AAO)
Stress tests before surgery (SVM)

Other

Back pain: Imaging tests (AAFP)
Headaches: Drugs for migraines (AAN)
Headaches: Imaging tests (ACR)
Heartburn and GERD (AGA)
Kidney disease: Hard choices (ASN)
Kidney disease: Pain relievers (ASN)
Lyme disease testing: When you need it (ACR)
Osteoporois: Bone-density testing (AAFP)
Sexual dysfuntion in men: Testosterone (AUA)

Women's health

Breast cancer: Imaging tests (ASCO)
Cervical cancer: Pap smears (AAFP)
Maternity care: Scheduled early deliveries (ACOG and AAFP)
Ovarian cysts: Imaging tests (ACR)