The American Board of Internal Medicine worked with numerous specialty organizations to arrive at a long list of tests and procedures that should be questioned before simply being requested/obtained. The list of questions that are relevant to radiology can be found here. The main site can be found here.

This initiative works in conjunction with the decision support efforts of companies such as National Decision Support and the American College of Radiology. Decision support is based on ACR Appropriateness criteria, guidelines which attempt to prioritize the applicability of a particular imaging study to a set of patient symptoms. By adhering to Appropriateness criteria, imaging requests should maximize positive studies while minimizing unnecessary scans. I previously blogged about these initiatives here.

The more we physicians understand and communicate the wisdom of choosing tests and procedures appropriately, the more patient care will be enhanced. We radiologists, in particular, are in a unique opportunity to assist our clinical colleagues with their decision-making process. Increased physician collaboration will enhance patient care, increasing the quality of delivered care and decreasing costs by reducing unnecessary tests and procedures.

Patients, in addition, would be well-advised to inquire of their physician what information may be gained by a particular test or procedure. We are all patients at one time or another. More than ever before, now is the time to work together as patients and doctors. Health care reform is discussed by everyone and with good reason - it affects us all. Improvements can only occur when everyone works together to better understand the goals of decisions being made. Your life depends on your involvement.