(WAVY) – According to the Society of General Internal Medicine, there are five things physicians and patients should question.
- Don’t recommend daily home glucose monitoring in patients who have Type 2 diabetes mellitus not using insulin.
Self-monitoring is essential of patient self-management in maintaining safe and targeted glucose control in type 1 diabetes mellitus, but for those with type 2 diabetes who are not on insulin or medications associated with hypoglycemia, daily glucose monitoring has been shown to have a small statistical significance, but is not clinically important in changes in glucose control, and small but significant patient harms associated with it.
- Don’t perform routine annual checkups unless patients are likely to benefit.
It recommends that the frequency of checkups should be based on individual risk factors and preferences, and said not to do comprehensive physical exams or routine lab testing during checkups.
It said those who would most benefit from routing annual checkups are those who are overdue for routine preventative car or are at high-risk of undiagnosed chronic illness. They also are people who rarely see their primary care physician, have low self-rated health or have a high degree of worry.
- Don’t perform routine pre-operative testing before low-risk surgical procedures.
The Society of General Internal Medicine said the goal of preoperative evaluation is to ID, stratify and reduce the risk for major post-operation complications, and said the crucial elements of this evaluation are “a careful history and physical examination.” It said pre-operation testing prior to low-risk surgeries “typically does not reclassify the risk estimate established through the history and physical examination, may result in unnecessary delays, lead to downstream risk from additional testing and add unnecessary costs.”
- Don’t recommend cancer screening in adults with a life expectancy of less than 10 years.
For at-risk patients, cancer screening can be life-saving, but if a patient’s life expectancy is less than 10 years, they are unlikely to live long enough to get the distant benefit from screening.
- Don’t place, or leave in place, peripherally inserted central catheters for patient or provider convenience.
The Society of General Internal Medicine said that they are commonly used devices “that are associated with costly and potentially lethal healthcare-acquired complications.”
It said that its advice is not intended to be a substitute for consulting with a medical professional, and that any patient with specific questions should speak with their physician.