Medical Tests that May Be Unnecessary (VIDEO)
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US News Releases Top Nursing Homes (VIDEO)
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Medical Tests that May Be Unnecessary
The “Choosing Wisely” campaign routine releases information on tests that they find potentially unnecessary and sometimes harmful. An additional 18 lists of tests or procedures to question have been added.
To date, more than 130 tests and procedures to question have been released as part of the ABIM FoundationÛªs campaign, which aims to spark conversations between patients and physicians about what care is really necessary.
- DonÛªt schedule non-medically indicated inductions of labor or cesarean deliveries before 39 weeks, 0 days of pregnancy. Delivery prior to 39 weeks is associated with increased risk of learning disabilities, respiratory problems and other potential risks.
- DonÛªt use feeding tubes in patients with advanced dementia. Studies show that percutaneous feeding tubes do not result in better outcomes for these patients.
åÊ - DonÛªt perform routine annual Pap tests in women 30 ÛÒ 65 years of age.
In average-risk women, routine annual Pap tests (cervical cytology screenings)
offer no advantage over screenings performed at three-year intervals.
åÊ - DonÛªt automatically use CT scans to evaluate childrenÛªs minor head injuries. Approximately 50 percent of children who visit hospital emergency departments
with head injuries are given a CT scan. CT scanning is associated with radiation exposure that may escalate future cancer risk.
åÊ - Avoid doing stress tests using echocardiographic images to assess cardiovascular
risk in persons who have no symptoms and a low risk of having coronary disease.
åÊ - When prescribing medication for most people age 65 and older with type 2 diabetes,åÊavoid attempting to achieve tight glycemic control.
åÊ - DonÛªt perform EEGs (electroencephalography) on patients with recurrent
headaches. Recurrent headache i the most common pain problem,
affecting up to 20 percent of people. The recommendation states that EEG
has no advantage over clinical evaluation.
åÊ - DonÛªt routinely treat acid reflux in infants with acid suppression therapy. Anti-reflux
therapy, which is commonly prescribed in adults, has no demonstrated effect in reducing the symptoms of gastroesophageal reflux disease (GERD) in infants, and there is emerging evidence that it may in fact be harmful in certain situations.
Nursing Home Care in Maine Something to Emulate
Recently U.S. News & World Report released its fifth annual list of best nursing homes. Its five-star rating system is based on Centers for Medicare & Medicaid Services data related to care quality, health inspection findings and staffing levels.åÊ
More than 15,000 nursing homes are included in the ratings, which are broken down by state, region and metro areas. U.S. News identified 3,036 homes that earned an overall five-star rating, based on CMS data from January 2013. This is up from 2,486 a year ago. U.S. News updates its ratings quarterly to reflect changing CMS information.
Looking at the five states the 2010 U.S. Census identified as having the most seniors as a percentage of population, Maine scored best on the U.S. News ratings. Thirty percent of its homes earned a five-star rating. Florida, No. 1 for seniors as a percentage of population, saw one-fifth of its homes earn the highest rating. The No. 2 state in seniors as percentage of the population, West Virginia, had only 10% earn the top rating. Pennsylvania and Iowa, Nos. 4 and 5, respectively, both saw 23% of their nursing homes earn five stars.åÊ
Something in the water in Maine. Perhaps you want to see what they are doing there that you can demand from your providers elsewhere. I have a colleague there. I will ask him and perhaps he can write a guest blog.
Of course take these rating with a grain of sand. Yes they should be one data point from which to choose but there is so much more including online sources and the old reliable word of mouth and asking around.åÊ
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Creating a Meaningful Life (VIDEO)
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