In the United States a working group named “the good stewardship working group” published on line on the Archives of Internal medicine an interesting article about 5 top recommendations about primary care activities that, if applied, should enhance security, cost-effectiveness and efficacy in ambulatory cares. Curiously the five top recommendations begin by “no”!!!!
1. No MRI or other imaging tests for low back pain, unless it has persisted longer than six weks or there are red flags, such as neurological problems.
2. No antibiotics for mild to moderate sinusitis, unless it has lasted a week or longer. Or the condition worsens after first getting better.
3. No annual electrocardiograms for low-risk patients without cardiac symptoms.
4. No Pap tests in patients under 21, or women who’ve had hysterectomies for non-malignant disease.
5. No bone scans for women under 65 or men under 70, unless they have specific risk factors.
We are thanskfull to Kaiser Health New who signaled us this paper.