A List of Things that Patients Should Question

I just learned about the Choosing Wisely campaign. It’s pretty amazing. The goal is to get each major medical specialty society in the US to make a list of 5 commonly done things that doctors and patients should question.

Being a patient is hard. People tell you that you are in large part responsible for your own care–but you are not a medical expert. When do you trust your doctor’s opinion? When do you need to do your own research? How many people are actually capable of doing this kind of research? The whole thing can be nerve-racking, especially if you are dealing with a serious health condition.

imgres-1The Lists for Choosing Wisely are still being written, but many are up on the website already. I wish they were being publicized more. I’d never heard of them until I happened on an article about the campaign in JAMA, and I doubt many other non-MDs are familiar with them either. I even asked a couple of MD acquaintances, and they hadn’t heard of these lists.

If you want to see them, you can check them out here. Unfortunately, they are not especially easy for patients to sort through. They may be helpful, though, especially if you know what you’re after. Take the American Academy of Pediatrics recommendations. Some are pretty well-known (no cough/cold meds for small children, no antibiotics for viral respiratory infections) but others might be less widely known (they all deal with common situations in which CT scans are not necessary–it was stuff I didn’t know).

Here’s a more user-friendly facet of the website: If you have questions about a particular condition/procedure, you may be able to find a fact sheet on it (look at the column on the left). Do you need a PAP smear? Maybe not! But you may have to convince your gynecologist of that. Are you thinking about scheduling an early delivery for your baby? Maybe not a great idea. But again, you might end up arguing with your OB about it. Need help controlling your migraines? Might want to avoid certain drugs. These fact sheets are being developed by Consumer Reports, so hopefully they will get disseminated widely. It’s a really nice idea!

One thing I like about this campaign is that it might give patients stronger footing when they decide to question a medical recommendation. Lots of times physicians recommend treatments that aren’t backed up by evidence, but patients are hesitant to speak up. Maybe this will give them (us) a little more confidence. It also may help people sort through the credible research and all the crazy stuff you find when you do a health-related internet search.