Doctors warn about un-needed medical tests, treatments

You don’t need an MRI for lower back pain. You don’t need antibiotics for a sinus infection. And you don’t need to be screened for osteoporosis, either, if you’re under 65.

Seventeen of the top medical specialty groups, representing pediatricians, ear, nose and throat specialists, family doctors and others released their latest list of common tests, treatments and procedures that people don’t need.

Some can do harm, like unnecessary antibiotics. Others are simply helping to drive up medical costs.

“Millions of Americans are increasingly realizing that when it comes to health care, more is not necessarily better,” says Dr. Christine Cassel, president and CEO of the ABIM Foundation, a non-profit set up by the American Board of Internal Medicine that helps sponsor the what-you-don’t-need campaign.

“Through these lists of tests and procedures, we hope to encourage conversations between physicians and patients about what care they truly need.”

Here are some of the things the groups say patients don’t need:

• Antibiotics for a sinus infection. While 80 percent of patients with sinusitis get one, most such infections are caused by viruses, which antibiotics don’t affect. You also usually don’t need an X-ray, CT scan or MRI, the American Academy of Otolaryngology — Head and Neck Surgery Foundation says.
• Induced labor or a cesarean section before a full 39 weeks of pregnancy, unless there’s a medical reason to do it. Babies delivered early can have lung problems, learning difficulties and other issues, the American College of Obstetricians and Gynecologists; American Academy of Family Physicians both say.
• A stress test when there’s no sign of heart disease. There’s no evidence it shows anything in a healthy person, the American Society of Echocardiography says.
• A feeding tube in patients with advanced dementia. Studies show it’s of no help to the patient, theAmerican Academy of Hospice and Palliative Medicine and American Geriatrics Society say. Hand-feeding is better.
• A routine annual Pap test if you’re 30 or older, or under 21. You only need one every three years, unless you’ve had an abnormal test, theAmerican College of Obstetricians and Gynecologists says. And women under 21 are extremely unlikely to have cervical cancer.
• DEXA (dual-energy X-ray absorptiometry) screening for osteoporosis in women under 65 or men under 70, unless there’s a suspicion of bone loss.
• A CT scan for a child with a minor head injury. While50 percent of children who visit hospital emergency departments with head injuries get one, they can raise the risk of cancer down the road, the American Academy of Pediatrics says.
• An EEG (electroencephalography) for patients with recurrent headaches. There’s no evidence it provides any benefit, theAmerican Academy of Neurology says.
• Any kind of imaging for lower back pain unless there are special circumstances, such as neurological deficits, or if the pain has lasted for more than six weeks.
• Antibiotics for pinkeye (conjunctivitis). It’s almost always caused by a virus, the American Academy of Ophthalmology says.
• PET or CT scans to screen for cancer in healthy people. “The likelihood of finding cancer in healthy adults is extremely low (around 1 percent), based on studies using PET/CT for screening,” the Society of Nuclear Medicine and Molecular Imaging says.