Patient Care
Gone Wrong:
5 Overused Procedures

How many of these tests / procedures do you perform or order? They may be unnecessary, at least in certain circumstances. As part of the "Choosing Wisely" campaign, an initiative of the ABIM Foundation and Consumer Reports, the American Chiropractic Association has released a list of five tests and procedures chiropractors commonly order or perform, but are not always necessary:

1. X-rays for acute LBP patients in the first six weeks following onset of pain and in the absence of red flags.
2. Monitoring patient progress with repeat spinal imaging / X-rays.
3. Ongoing or prolonged use of passive or palliative physical therapy treatments (heat, cold, e-stim, ultrasound, etc.) for LBP that does not support the goals of an active treatment plan.
4. Long-term pain management without screening for potential related psychological disorders such as depression or anxiety.
5. Prescription of lumbar supports or braces for long-term treatment or prevention of LBP.

The ACA Committee on Quality Assurance and Accountability developed the Choosing Wisely recommendations following an extensive review process that included a comprehensive search of current scientific evidence. The ACA Board of Governors approved the final list.

Announced in 2011 and officially launched a year later, the Choose Wisely campaign "is part of a multi-year effort led by the ABIM Foundation to support and engage physicians in being better stewards of finite health care resources. Participating specialty societies are working with the ABIM Foundation and Consumer Reports to share the lists widely with their members and convene discussions about the physician's role in helping patients make wise choices."

More than 70 medical specialty societies currently participate in the campaign and have released over 400 recommendations regarding overused tests / treatments. Recommendations have appeared in nearly 300 journal articles and 10,000-plus media articles thus far.

"We are proud to partner with Choosing Wisely in this effort to encourage important conversations between patients and chiropractors that may reduce unneeded or overused services, yielding the best possible patient care," said ACA President David Herd, DC, in the association's press release announcing its participation and revealing the list of potentially unnecessary services.

To learn more about the Choose Wisely campaign, click here.