Seattle — The Washington Health Alliance and Washington Choose Wisely Task Force recently published a report that identifies overused medical procedures and services in our state. The results are based on a survey taken by 2.4 million Washingtonians. It looked at 47 commonly done treatments and procedures to determine how often they are done appropriately, or inappropriately.
The survey determined that just 11 tests accounted for the vast majority of wasteful health care spending.
“We’ve taken that data,” says Premera Blue Cross’ Dr. David Buchholz, “And now we’re starting to share it to make sure people ask the right questions when these procedures are being recommended.”
Knowing what questions to ask can help lower an individual’s medical costs, and increase efficiency in their treatment. No one wants to have a procedure they don’t need to have.
At the top of the list – too frequent pap smears for women. These are common tests that women get at an annual checkup that are used to look at a sample of cells from a woman’s cervix to test for cervical cancer.
“It’s important to test to get at the right intervals,” says Dr. Mia Wise, “What medical experts used to believe is that any abnormal cells that were seen on a pap smear were destined to become either pre-cancer or cancer. What we now know is that a significant number of those abnormalities can, in fact, revert back to healthy and normal tissue. We do a better job of identifying the important abnormalities when we screen less frequently.”
The top 11 overused services as determined by the Washington Health Alliance / Washington Choose Wisely Task Force report are:
- Too frequent cervical cancer screenings in women
- Preoperative baseline laboratory studies prior to low-risk surgery
- Unnecessary imaging for eye disease
- Annual EKGs or cardiac screening in low risk, asymptomatic individuals
- Prescribing antibiotics for acute upper respiratory and ear infections
- PSA screening
- Population-based screening for OH-Vitamin D deficiency
- Imaging for uncomplicated low back pain in the first six weeks
- Preoperative EKG, chest x-ray and pulmonary function testing prior to low-risk surgery
- Cardiac stress training
- Imaging for uncomplicated headaches
Dr. Buchholtz says what’s important to take away from this survey are five questions to ask your doctor when one of these treatments or procedures is proposed:
- Do I really need to take this test, or take this treatment plan? Ask this question to make sure you understand what it’s all about, so you can make an informed decision on how to move forward.
- What are the potential side effects of the treatment or risks associated with the procedure?
- Are there simpler, safer options? If the side effects are worrisome to you, ask your Doctor if there is something simpler or easier to do that doesn't have so many side effects, but might get you to the desired goal.
- What happens if I don’t do anything?
- How much does it cost and will my insurance pay for it? Often patients think because their doctor has recommended something that insurance will pay for it, but often that is not the case. Dr. Buchholz says, “Doctors often know relative costs, but it’s almost impossible for a Doctor to understand all the nuances of an insurance policy.” What they can do is refer you to one of their business people to get a better sense of the overall cost. Most insurance plans, like Premera, have transparency tools on their website, that helps you to thoroughly research a procedure and the costs. “It’s a good question to start with a Doctor, but they’re not going to have definitive answers,” he says.
Many patients are afraid of having this conversation, as they don’t want to insult their doctors or sound like they are second guessing them.
“That is actually a common concern, “ says Dr. Buchholz, “But we need to realize that Doctors are just people too. Normal people that are just trying their best to make sure that their patients get the best possible care.” He suggests bringing the questions with you to an appointment in order to start the conversation.
If you feel like your physician is not doing a good job of answering questions or listening to your concerns, trust your instincts and look for other ways to get the information or the assurance that you need. Don’t be afraid to get a second opinion.
This segment is sponsored by Premera Blue Cross. Watch New Day Northwest 11:00 weekdays on KING-TV Ch.5 or streaming live on KING5.com. Connect with New Day via Facebook, Twitter, Instagram.
