Doctors have long known that some of the care they provide is unnecessary: Think antibiotics for sinus infections, MRIs for lower back pain, CT scans for headaches, and chest X-rays before routine surgery. Such care is not only often a waste of money, but can also be dangerous, in some cases exposing you to drug side effects, possibly harmful radiation, and other risks. Yet doctors often order those tests and treatments, in part because of pressure from patients, advertising, and the fact that doctors often get paid more for doing more, not less.

To combat that problem, more than 70 medical specialty societies, such as the American Academy of Family Physicians, the American College of Radiology, and American Society of Nephrology, contributed to a campaign called Choosing Wisely that hopes to rein in overuse. So far the campaign has identified more than 400 tests and treatments that doctors and patients should talk about before ordering.

But a new study has found that, for at least some of these conditions, doctors apparently have been slow to embrace their own movement.

Too Many Tests

The study, published in the journal JAMA Internal Medicine, found promising decreases, of about 10 percent, in how often doctors ordered two things known to be overused:

  • CT scans and MRI imaging tests for people with uncomplicated headaches.
  • EKGs and exercise stress tests in patients who have no history or symptoms of heart conditions.

But for five other overused procedures, the prevalence remained the same or even grew:

  • Anti-inflammatory painkillers such as ibuprofen, naproxen, and celecoxib for people with high blood pressure, heart failure or chronic kidney disease
  • Antibiotics for sinus infections
  • HPV testing to screen for cervical cancer, in women under 30
  • Chest X-rays before many surgeries
  • MRIs, X-rays, and CT scans for lower back pain.

To be fair, the study was limited. It covered just seven of the Choosing Wisely measures, early in the campaign. (The campaign was launched in April 2012, and the latest study data were from 2013). Also, the study is based on one nationwide commercial insurance company's payment records, which is not necessarily an accurate view of what all patients and doctors are doing in the exam room.

Still, the study underscores how hard it can be to get doctors and patients to change entrenched habits.

“It is a courageous step for health care providers to question their own behavior and to talk to their patients about why less is sometimes more," says Tara Montgomery, senior director for Health Impact at Consumer Reports. “The true test of the Choosing Wisely movement  is not the number of procedures but the number of conversations. The reduction in utilization and waste will eventually follow.”

5 Questions to Ask

To help in that effort, Consumer Reports has created free brochures on more than 100 of these overused tests and treatments, for you to use when discussing your health care.

Of course, it’s often hard to raise these issues with your doctor. So here are the five questions you should always ask your doctor.

  1. Do I really need this test or procedure?
  2. What are the risks and side effects?
  3. Are there simpler, safer options?
  4. What happens if I don’t do anything?
  5. How much does it cost?

To remember them: print this wallet card and tuck it next to your insurance card, so it's always with you at the clinic.