Internists Choosing Wisely: No Checkups for Healthy Adults

Larry Hand

September 12, 2013

The Society of General Internal Medicine (SGIM) released a statement today recommending that internists avoid 5 common, but not always necessary, tests or procedures. The evidence-based recommendations, which are part of the Choosing Wisely campaign, are:

  1. "Don't recommend daily home finger glucose testing in patients with Type 2 diabetes mellitus not using insulin.

  2. Don't perform routine general health checks for asymptomatic adults.

  3. Don't perform routine pre-operative testing before low-risk surgical procedures.

  4. Don't recommend cancer screening in adults with life expectancy of less than 10 years.

  5. Don't place, or leave in place, peripherally inserted central catheters for patient or provider convenience."

The AGIM statement follows closely statements issued by 2 surgical societies as part of the Choosing Wisely campaign, which was initiated by the American Board of Internal Medicine Foundation.

"Physicians in General Internal Medicine have a special long-term relationship with their patients," Laurence F. McMahon, MD, MPH, from the University of Michigan Medical Center, Ann Arbor, and chair of the SGIM ad hoc Choosing Wisely committee, said in an SGIM news release. "Our goal is to maintain our patients' health and function, to treat their acute and chronic diseases, and to coordinate care with other specialties on behalf of our patients. The Choosing Wisely topics seek to identify areas where we can engage our patients in conversations designed to enhance their health across this spectrum of practice. We are proud to engage in this specialty-defined Choosing Wisely effort to enhance care on behalf of our patients,"

SGIM President Eric B. Bass, MD, MPH, from Johns Hopkins University School of Medicine in Baltimore, Maryland, said in the news release, "We believe that general internists have an important role to play in helping patients make informed decisions about tests and procedures that may otherwise be used too often."

An ad hoc committee developed the recommendations based on strength of evidence, "the unique standing" SGIM members have in addressing the selected topics and the contribution the recommendations would make in terms of patient safety, quality of care, and healthcare costs.

About 30 specialty societies are expected to make similar Choosing Wisely statements during the coming months.

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