Choosing Wisely® Campaign Adds Five More “Things Physicians and Patients Should Question” to Prevent Unnecessary Tests and Procedures

The American Medical Society for Sports Medicine (AMSSM) recently updated its Choosing Wisely® recommendations to include five new suggestions to reduce low-value or overutilized medical services.

Choosing Wisely is an initiative spearheaded by the ABIM Foundation, drawing on the expertise and recommendations of medical societies like AMSSM, to identify and prevent unnecessary tests and treatments that burden the system with overutilization.

AMSSM’s participation in the Choosing Wisely initiative is led by Health Care Transformation and Quality Initiatives Subcommittee chair Luis Rodriguez, MD, FAMSSM.

The five new Choosing Wisely recommendations include:

• Do not forget to routinely assess activity levels and recommend appropriate physical activity to your patients.
• Do not order ankle or midfoot X-rays for patients older than 6 years old without positive criteria per the Ottawa ankle rules.
• Consider evaluating rotator cuff tears with ultrasound before ordering an MRI.
• Do not cast or perform follow-up x-rays for isolated, non-displaced/non-angulated distal radius buckle fractures that do not involve the physis and which have an intact cortex in children.
• Do not delay initiation of early sub-threshold, symptom-limited aerobic exercise as rehabilitation for adolescents who have sustained an acute sport-related concussion.

These guidelines join five initial recommendations, originally developed in 2014, to make up the Ten Things Physicians and Patients Should Question. AMSSM’s goal is to identify common topics in the practice of sports medicine that would lead to significant health benefits and a reduction of common procedures that can be unnecessary or cause harm.

The mission of Choosing Wisely is to promote conversations between clinicians and patients by helping patients choose care that is:

• Supported by evidence
• Not duplicative of other tests or procedures already received
• Free from harm
• Truly necessary

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

For more information, visit choosingwisely.org.

About the AMSSM

AMSSM is a multi-disciplinary organization of sports medicine physicians dedicated to education, research, advocacy and the care of athletes of all ages. The majority of AMSSM members are primary care physicians with fellowship training and added qualification in sports medicine who then combine their practice of sports medicine with their primary specialty. AMSSM includes members who specialize solely in non-surgical sports medicine and serve as team physicians at the youth level, NCAA, NFL, MLB, NBA, WNBA, MLS and NHL, as well as with Olympic and Paralympic teams. By nature of their training and experience, sports medicine physicians are ideally suited to provide comprehensive medical care for athletes, sports teams or active individuals who are simply looking to maintain a healthy lifestyle. www.amssm.org