AIIMS doctors lead the way, wage war on unnecessary medical tests

NEW DELHI: Top cardiologists of the All India Institute of Medical Sciences (AIIMS) here have decided to start an initiative called the Society for Less Investigative Medicine (SLIM) — a movement that aims to take on the growing menace of excessive medical investigations, starting with cardiology.

Several studies across the world have conclusively established that generalized annual health check-ups are unnecessary and add enormously to healthcare costs without any commensurate benefits. Several other screening tests and investigations have also been similarly shown to make little sense — other than adding to the bank balance of diagnostic centres and doctors who get a cut for sending patients for tests and investigations.

This unhealthy practice has prompted Prof Balram Bhargava of the cardiology department in AIIMS, one of the key people behind SLIM, to raise an alarm over over-investigation, a practice that has become rampant simply because economic incentives were skewed in favour of recommending unnecessary tests

“But there is no regulation or audits on investigations to determine if they are necessary,” said Dr Bhargava. “Even in the US, where privatization is rampant, there are audits and guidelines regarding investigations, and the health information technology used in most of the developed countries make it possible to retrieve and check data to see if a particular investigation or procedure was necessary. We need similar checks in India to stop this practice. Rather than preventive check-ups of CT scans, angiograms and treadmill tests every year, it’s more useful to track risk factors,” said Dr Bhargava.

He pointed out that the government too was wasting a lot of money by offering annual health check-up to its Group ‘A’ officers above 40 years of age under the Central Government Health Scheme.

‘Need checklist on symptoms that warrant tests’

Already a number of top doctors have endorsed the scathing criticism of Dr Samiran Nundy, one of India’s leading gastroenterologists, of kickbacks and bribes that oil every part of the healthcare machinery (as reported by TOI on Saturday ). One of the doctors, Dr MK Mani, chief nephrologist in Apollo Hospital in Chennai, has drawn MCI’s attention to this — but to no avail

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