The Overuse of Diagnostic Imaging and the Choosing Wisely Initiative

Health care in America costs too much. There are manyreasons for this, but an important one is the overuse of diagnostic tests—including but not limited to imaging studies. A report by Iglehart (1) indicated that, between 2000 and 2007, use of imaging studies grew faster than that of any other physician service in the Medicare population. Another report by the influential group America’s Health Insurance Plans (2) claimed that 20 % to 50 % of all “high-tech ” imaging provide no useful information and may be unnecessary. Reports like these have led to cost concerns among key federal agencies like the Congressional Budget Office, Government Accountability Office, and Medicare Payment Advisory Commission (3, 4), and steps have been taken in recent years to reduce reimbursements for imaging (3). However, an even better approach might be to try to limit imaging studies and other tests and treatments that are inappropriate, unnecessary, wasteful, or redundant. In an attempt at this latter option, the American Board of Internal Medicine Foundation worked with Con-sumer Reports to conceive and organize the Choosing Wisely initiative (5). The Foundation brought 9 other leading medical organizations into the campaign: the