Doctors Back Top 5 Ways to Cut Primary Care Costs

There’s no doubt about it, people love lists. In that vein, the National Physicians Alliance issued two Top 5 lists of recommendations that it hopes will capture the attention of physicians -- and their patients -- to improve quality of care and lower costs.

The recommendations focused on reducing the number of tests ordered, and in some cases limiting antibiotic prescriptions and over-the-counter medications. The report was published online Monday and is scheduled to appear in the Aug. 8 edition of Archives of Internal Medicine.

To come to a consensus on the recommendations, a total of 255 field testers completed online surveys rating each suggestion how it would affect patient care and cost.

“Physician panels in the primary care specialties of family medicine, internal medicine, and pediatrics identified common clinical activities that could lead to higher quality care and better use of finite clinical resources. … We recommend that these "Top 5" lists of activities be implemented in primary care practice across the United States,” the report concluded.

Here are the NPA’s Top 5 healthcare cost-cutting recommendations for internal medicine and primary care:

Top 5 Ways to Improve Family Medicine
  • Lower Back Pain: No imaging for lower back pain within the first six weeks, unless there are red flags present.
  • Sinusitis: Don't prescribe antibiotics for sinusitis unless symptoms -- including purulent nasal secretions and maxillary pain, or facial or dental tenderness to percussion -- last for seven days. (Or if symptoms worsen.)
  • EKGs: Don't order annual electrocardiograms or any other cardiac screening for low-risk patients.
  • Pap Smears: No Pap tests for patients below the age of 21, or for women who have had a hysterectomy for a benign disease;
  • Bone Scans: No DEXA screening for osteoporosis in women below the age of 65, or for low-risk make patients under 70 years old.

Top 5 Ways to Improve Pediatrics
  • Do not prescribe antibiotics for pharyngitis, unless the patient tests positive for streptococcus.
  • Do not order diagnostic images for minor head injuries without loss of consciousness or other low-risk factors.
  • Don't immediately refer otitis media with effusion.
  • Recommend that patients avoid using cough and/or cold medicines.
  • Recommend using inhaled corticoseroids to control asthma.
Access the complete report here.