As part of the NPS Choosing Wisely campaign, 14 medical colleges in Australia have recently nominated certain common medical treatments as "wasteful" in an effort to reduce healthcare costs. Naturally, some are happy with the changes, and others are furious. Headlines in today's newspapers are carrying on about children being "left to suffer" instead of being allowed antibiotics for ear and upper respiratory infections, as well as paracetamol or aspirin to relive fever.
So what are the medicines and tests that doctors are now calling "unnecessary"? Here is the list:
1) Antibiotics for ear infections (especially 2-12 year old children)
2) Paracetamol or aspirin to control fever
3) X-rays of ankle or foot trauma
4) Chest X-rays for uncomplicated bronchitis
5) Routine colonoscopies
6) Antibiotics for upper respiratory tract infections
7) Long-term anti-inflammatories for elderly patients
8) X-rays for lower back pain
9) Repeated blood tests for people with fatigue
10) CT scans to check for appendicitis
Some of my classes had already discussed 1), as many ear infections are self-resolving, but I would say that they are sometimes necessary if the pain and inflammation haven't resolved in 2-3 days. There were a few natural remedies that we did talk about, but often there isn't much available for young children and their underdeveloped immune systems. I would also agree with 2), unless the fever is over 39 degrees Celsius or it's a baby under 3 months old (that is when you go straight to hospital, no baby under 3 months should be allowed to have a fever). As for 3), 4), 8) and 10), diagnostics are not my specialty, but with 5) I would also agree with their admission of the dangers of colonoscopy. It's invasive and you can disrupt the gut bacteria, which help to regulate immunity and may even make or break the effectiveness of new immunotherapy drugs for cancer. However, I would not say that antibiotics for upper respiratory infections are always unnecessary, I have needed them in the past and depending on age (ie children) and severity, antibiotics may be needed alongside natural medicines. Anti-inflammatory drugs can have devastating side effects because of their suppression of protein synthesis, so I agree with 7) as there are plenty of natural alternatives that can be very effective. This includes but is not limited to turmeric, frankincense and ginger, but please see a Bachelor-qualified naturopath if you want to heal inflammation naturally and especially if you want to stop corticosteroids. For 9) I would say that often the wrong things are tested for when someone presents with fatigue, what needs to be tested for is up to the individual.
Overall? I see these new guidelines as a mixed blessing. They may benefit some, may harm others and may open up some more minds to natural therapies.