Primary Care’s “Top 5” List

Kenneth Lin

First published 5/30/11 on the AFP Community Blog

Last week, the journal Archives of Internal Medicine published “The ‘Top 5’ Lists in Primary Care,” a physician-authored consensus statement that recommended five activities each for the specialties of family medicine, internal medicine, and pediatrics to pursue to reduce waste and improve quality. Here is the top 5 list for family physicians, together with related online resources from AFP By Topic collections:

1) Don’t do imaging for low back pain within the first 6 weeks unless “red flags” are present.

AFP By Topic: Muculoskeletal Care – Neck and Back

2) Don’t routinely prescribe antibiotics for acute sinusitis.

AFP By Topic: Upper Respiratory Tract Infections – Treatment

3) Don’t order annual ECGs or any other cardiac screening for asymptomatic, low-risk patients.

AFP By Topic: Coronary Artery Disease – Screening and Diagnosis

4) Don’t perform Pap tests on women younger than 21 years or in women status post hysterectomy for benign disease.

AFP By Topic: Cancer – Cervical Cancer

5) Don’t use DEXA screening for osteoporosis in women under age 65 years or in men under 70 years with no risk factors.

AFP By Topic: Osteoporosis – Screening and Diagnosis

As a reminder, AFP By Topic is also available as a free mobile app in the Apple Store and the Android Market.

Kenneth Lin is a DC-based family physician who blogs at Common Sense Family Doctor.

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