Don’t Do List for Family Physicians

The National Physicians Alliance has examined the evidence and published a short list of what is often ordered without justification by family physicians: X-rays for low back pain without unusual red flags within the first 6 weeks of pain, antibiotics for sinusitis in the first 7 days unless symptoms worsen after initial improvement, annual screening EKGs for asymptomatic patients, pap tests in patients less than 21 years old or in those who have had hysterectomies for benign disease, and DEXA scans for women under 65 or men under 70 with no risk factors. I agree. However, low back pain and sinusitis can be aggressively treated with natural remedies that do not carry the risk of standard meds, and ultrasound heel scanning can detect and monitor osteopenia quite well without the risk of radiation. See Arch. Intern. Med. 2011, p. 231, reported in Family Practice News (click here), June 1, 2011, p. 44.