Fewer tests, less antibiotics improve primary care

If primary-care doctors want to improve the quality of care and save limited clinical resources, they need look no further than the top five treatment recommendations from the National Physicians Alliance.

Following these evidence-based recommendations--which call for ordering fewer tests and prescribing fewer antibiotics--will help doctors make wiser clinical decisions that will lead to significant health benefits, as well as reduce risks, harms and costs, notes the physician group.

The "Top 5" lists for PCPs in family medicine, internal medicine and pediatrics all are included in a study published online yesterday in the Archives of Internal Medicine.

According to the lists, PCPs in internal and family medicine can avoid overimaging by not ordering diagnostic imaging for patients with lower back pain for six weeks unless certain red flags are present.

The doctors also are advised to not order annual electrocardiography, or other cardiac screening, for patients who are low risk and have no symptoms. Doing so can cut back on unnecessary invasive procedures, over-treatment and misdiagnosis.

The NPA insists that primary-care physicians in internal medicine also would be wise to use only generic statins when initiating lipid-lowering drug therapy, thereby cutting costs without comprising quality of care.

For pediatricians, the physician group urges PCPs to use inhaled corticosteroids to control asthma appropriately, and not to prescribe antibiotics for a sore throat unless the patient tests positive for strep.

"Having such endorsements will help dispel the misconception that these clinical recommendations represent rationing and support the idea that often less is truly more," notes the study.

For more:
- here's the study abstract
- read the Penn Medicine press release
- read this Wall Street Journal article