Do you really need that MRI for your back? How about those antibiotics to treat a sinus infection? Women, is that annual routine Pap test really going to help you or can you go every other year with the same benefits?

A new website, www.ChoosingWisely.org, helps you and your doctor determine whether commonly prescribed tests, procedures and medications are necessary. I’m impressed with this “movement” to put information in consumers’ hands because the advice is medically sound (by physicians’ groups). Even though it’s a national news story, it has very local implications. We’re all facing rising out-of-pocket medical costs, and we don’t want unnecessary care.

You’ll be surprised how much medical care is unnecessary—even harmful.

Here’s the scoop: So far, more than 130 tests and procedures to question have been released as part of the ABIM Foundation’s Choosing Wisely campaign. Each medical specialty society participating in Choosing Wisely identified five specific tests or procedures that are commonly done in their profession, but whose use should be questioned. And the lists keep coming in as more and more societies come onboard with Choosing Wisely.

These are just some of the tests, procedure and medications you should talk with your doctor about before you agree to go forward:

• Don’t perform routine annual Pap tests in women 30 – 65 years of age. In average-risk women, routine annual Pap tests (cervical cytology screenings) offer no advantage over screenings performed at three-year intervals.
(source; American College of Obstetricians and Gynecologists)

• Don’t automatically use CT scans to evaluate children’s minor head injuries. Approximately 50 percent of children who visit hospital emergency departments with head injuries are given a CT scan. CT scanning is associated with radiation exposure that may escalate future cancer risk. The recommendation calls for clinical observation prior to making a decision about needing a CT. (American Academy of Pediatrics)

• Avoid doing stress tests using echocardiographic images to assess cardiovascular risk in persons who have no symptoms and a low risk of having coronary disease. The recommendation states that there is very little information on the benefit of using stress echocardiography in asymptomatic individuals for the purposes of cardiovascular risk assessment, as a stand-alone test or in addition to conventional risk factors. (American Society of Echocardiography)

• When prescribing medication for most people age 65 and older with type 2 diabetes, avoid attempting to achieve tight glycemic control. The recommendation states that there is no evidence that using medicine to tightly control blood sugar in older diabetics is beneficial. In fact, using medications to strictly achieve low blood sugar levels is associated with harms, including higher mortality rates. (American Geriatrics Society)

• Don’t perform EEGs (electroencephalography) on patients with recurrent headaches. Recurrent headache is the most common pain problem, affecting up to 20 percent of people. The recommendation states that EEG has no advantage over clinical evaluation in diagnosing headache, does not improve outcomes, and increases costs.
(American Academy of Neurology)

• Don’t routinely treat acid reflux in infants with acid suppression therapy. Anti-reflux therapy, which is commonly prescribed in adults, has no demonstrated effect in reducing the symptoms of gastroesophageal reflux disease (GERD) in infants, and there is emerging evidence that it may in fact be harmful in certain situations.
(Society of Hospital Medicine)

For more, check out www.ChoosingWisely.org.

Pedals up!

We’re only weeks away from the March 22 through 24 Delray Beach Twilight Festival, when Delray Beach’s Downtown Atlantic Avenue is the backdrop for sprint-style professional and amateur cycling races. Be among the spectators to line the streets along this one-kilometer course, as cyclists whiz around, competing at fast speeds for prize money.


Amateur cyclists looking for a less competitive experience (I’m one), still have time to sign up for various events during the weekend, including a 62- or 37-mile ride along A1A that Sunday. To sign up or find out more, go to http://delraybeachtwilight.com/.

Attention Triathlon-ers…

Long-time local triathletes might remember Steve Tebon. He founded Exclusive Sports Marketing, which for years put on South Florida triathlons. Tebon is back in promoting triathlon and has a big race coming up June 1. It’s The Motivation Man in Downtown West Palm Beach, Florida. The swim-bike-run event is in two distances: half iron and Olympic courses.
To find out more, go to http://www.motivationman.com/.

Good news on the quick

Boca Raton Regional Hospital recently celebrated the groundbreaking of its new $42 million Marcus Neuroscience Institute. Located on the hospital’s main campus, at 800 Meadows Road, Boca Raton, the 56,000-square-foot facility will serve as a new, state-of-the-art nexus of care for neurologic and neurosurgical patients. The Marcus Neuroscience Institute will be completed in spring 2014. For more information, visit http://www.brrh.com/neuroscience.aspx.