Doctors Get Plenty of Advice on Starting Treatment. This Could Help Them Stop

Medical experts have worked for decades to improve the chances that patients will get the scans, routine tests and medicines that can do them the most good – and avoid the ones that won’t help them at all.

But in the push toward evidence-based medicine, a new study says, a key step has mostly been overlooked: helping doctors stop or scale back – or de-intensify – treatment once it has started, and take the screening, testing and treatment down a notch as evidence or the patient’s health, age and lifestyle change.

To truly help patients, it’s time to include clear off-ramp instructions for providers and patients, especially in primary care, say the authors of a new study published in JAMA Internal Medicine.

They lay out a process for doing so, based on an intensive review of hundreds of recommendations built on reams of research and evidence. Backed by a panel of expert advisors from a wide range of fields, they identify an initial set of 37 specific instances where physicians could de-intensify care safely for certain patients.

“For many years, we’ve been focused on making sure patients get all the care they need, because there were deficits,” says Eve Kerr, M.D., M.P.H., lead author of the study and a professor in the Department of Internal Medicine at the University of Michigan and senior investigator at the VA Center for Clinical Management Research. “But there are times when patients are getting care too frequently or more intensely than they might have once needed. Those are opportunities to improve their care without harming their health, or perhaps even reducing risk and increasing quality of life.”

This article was originally featured in the University of Michigan Health Lab Blog, read more here.