The five most wasteful procedures in primary care Archives of Internal Medicine

his article from the Archives of Internal Medicine reviews the top five most wasteful procedures in primary care. The first was the ordering of diagnostic imaging such as x-rays, MRI's, and CT's. The second was ordering bone density testing in woman under 65 and men under 70 with no risk factors for osteoporosis.

We now know that diagnostic imaging has a high rate of false positives meaning it can show many abnormalities that have nothing to do with a patients symptoms. This leads to much unnecessary further testing and treatments, some of them with dangerous side effects.

Current guidelines do not recommend bone density testing on woman under 65 and men under 70 with no risk factors for osteoporosis for the same reasons as diagnostic imaging.

The "Top 5" Lists in Primary Care

Even short term use of anti-inflammatory drugs increases risk of death and heart attack in patients with cardiovascular disease

NSAID's (anti-inflammatory drugs) are contraindicated in patients with cardiovascular disease, but continue to commonly be prescribed to this group. This study showed that even short term use (1 day!) increased the risk of death and recurrent heart attacks in patients with previous heart attack! The research on the dangers of NSAID's keeps accumulating and is now quite extensive. Here is a link to the article in the journal Circulation.

Duration of Treatment With Nonsteroidal Anti-Inflammatory Drugs and Impact on Risk of Death and Recurrent Myocardial Infarction in Patients With Prior Myocardial Infarction

"America’s deadliest drug problem? Not heroin, not cocaine, not even crack cocaine. The larger problem is abuse of drugs that are perfectly legal: prescription pain medications. They kill an estimated two people every hour and send 40 more to emergency rooms with life-threatening overdoses."

It would be interesting to know how many lives are saved by patients choosing chiropractic treatment instead of drug treatment. Here is a link to the article.

When painkillers kill 2 people every hour, it's time to act