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Because we trust doctors and healthcare providers to give us the best care we may unwittingly be taking inappropriate medication or being subjected to unnecessary tests which could potentially be harmful. Now is the time to start asking questions!

Have you ever wondered if all the tests you had before surgery were really necessary, or if the antibiotics the doctor gave you for sinusitis were a good idea?  Many doctors feel under pressure to write prescriptions or order tests that are not in their patients’ best interests.  The reasons can vary from it being easier to prescribe than explain to the patient why it’s not needed, to physicians feeling they have to protect themselves from litigation

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What harm is there in unnecessary treatment or tests?

The risk of inappropriate treatment is exposure to harmful side effects, not balanced by any potential benefit.  

Unnecessary tests also run the risk of a false positive and all that entails.

This means the person is diagnosed with an illness or condition they don’t have, possibly receive needless treatment or interventions and experience stress as a result of the worry.

Antibiotics for sinusitis

It is estimated that antibiotics are inappropriately prescribed in 80% of episodes of mild to moderate sinusitis.  They’re generally not appropriate because sinusitis is most often are caused by viruses, and which are unaffected by antibiotics. 

In addition, many antibiotics are associated with side effects such as stomach upsets and disrupt the natural balance of bacteria and organisms.  Excessive and unnecessary use of antibiotics has also led to the current problems of growing numbers of drug-resistant bacteria making treatment of some diseases, such as tuberculosis, much harder than it used to be. 

The advice is to avoid antibiotics for sinusitis, which will usually clear up by itself.

The exceptions are if it persists longer than seven days, is severe, or worsens after first improving (which may indicate that a secondary bacterial infection has developed, against which antibiotics may be effective).

Expensive imaging for back pain

It is estimated that around 80% of us will develop low-back pain at some stage in our lives.  In the majority of cases this is due to poor posture, weak muscles or even the way we walk, and not to anything sinister.  It’s also a fact that most cases will improve in four to six week without any intervention.

So in the main, X-rays, CT scans and MRIs for low-back pain cause unnecessary exposure to radiation, not to mention unnecessary costs.

Also, age-related deterioration in the spine due to wear and tear will show up on imaging and could mislead a diagnosis and treatment.

But if you have other symptoms such as loss of feeling, pain that is severe or does not improve in four to six weeks, see your doctor.

Sleeping pills for insomnia

While it might seem handy to pop a pill for those sleepless nights, you could do better by seeking advice on non-drug ways of encouraging sleep.  

Some types of sleeping pill can become addictive and their effects can ‘hang over’ into the next day, disrupting normal life. 

This effect is also associated with increased risk of falls and broken hips in older people. 

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  • www. choosingwisely.org

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