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Small group of Ontario family MDs orders too many unnecessary tests, study finds

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A small group of Ontario family doctors is responsible for ordering a disproportionate amount of unnecessary screening tests on patients, new research shows.

A paper published Friday in JAMA Network Open found that 441 primary care physicians in the province order nearly 40 per cent of tests considered “low-value.”

This subset of the province’s 11,448 family doctors demonstrates “a general pattern of overuse,” according to the study by researchers at the Institute for Clinical Evaluative Sciences (ICES) and Women’s College Hospital.

Lead author Dr. Sacha Bhatia said the findings are relevant because they can help better target future efforts to reduce low-value care.

“The reality is that most doctors don’t get a lot of feedback on how they’re doing. But if we know who needs this the most, we can make big strides to improve the care patients get and save much needed health-care dollars in the process,” he said.

Researchers looked at the ordering rates of four low-value screening tests between 2012 and 2016. They correctly hypothesized that physicians who frequently order one of these tests are more likely to frequently order at least one of the others as well.

The four tests studied are:

  • Repeat bone density tests, formally known as dual-energy X-ray absorptiometry (DXA) scans. This kind of screening is done to look for conditions such as osteoporosis. Evidence shows there is little value in having more than one of these scans within a two-year period.
  • Electrocardiograms (ECGs) for patients 40 and older who are considered at low risk of cardiovascular disease.
  • Chest X-rays for patients at low risk for cardiopulmonary disease.
  • Pap tests on women younger than 21 and older than 69, a demographic considered at low risk for cervical cancer.

These four tests were studied because of an abundance of evidence showing they are overused and that there is much variation in how often doctors order them.

They have been identified as low-value by Choosing Wisely Canada, which is part of an international clinician-led campaign, running in 20 countries, aimed at reducing the frequency of low-value care.

Bhatia, a cardiologist, is the evaluation lead for Choosing Wisely Canada. He is the director of the Women’s College Hospital Institute for Health System Solutions and Virtual Care. Bhatia is also an adjunct scientist with ICES

He explained that low-value tests are not particularly helpful in diagnosing or treating disease. They also include tests for which the harms of undertaking them outweigh the benefits. For example, patients may be unnecessarily exposed to radiation.

Bhatia noted that it costs only about $5 to do one ECG. But the concern, he said, is that unnecessary ECGs are being done in large numbers and can result in patients getting even more tests they may not need. This is because screening tests can cause false positive results that require some further testing to rule out real disease. But this additional testing may be more invasive and expensive.

A report released last year by the Canadian Institute for Health Information and Choosing Wisely revealed that Canadians have more than 1 million potentially unnecessary tests, treatments and procedures annually.

The report found that 30 per cent of selected tests, treatments and procedures are potentially unnecessary. They waste health system resources, increase wait times for patients in need and can lead to patient harm.

The JAMA study was a retrospective one, which saw researchers pore over data on health-care claims held by ICES.

They identified 2,394 Ontario family doctors who see the most patients and order the most tests.

Researchers found that 18.4 per cent of this group — or 441 doctors — orders 39.2 per cent of all of the low-value tests.

“When you look at the overall trends on how doctors order these tests, most actually practise reasonably well. But for the minority who order these tests unnecessarily — the one in five — we can see clearly where there is a big opportunity for change,” Bhatia said.

Doctors with increased odds of frequently ordering low-value tests are male, further removed from medical school graduation (meaning they are older), and receive much of their income by billing OHIP on a fee-for-service basis. They are also more likely to be graduates of Canadian medical schools.

Theresa Boyle is a Toronto-based reporter covering health. Follow her on Twitter: @theresaboyle



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These US entities partnered with the Wuhan Institute of Virology — time for a criminal investigation?

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(Natural News) The Wuhan Institute of Virology from which the Wuhan coronavirus (COVID-19) is believed to have “escaped” has a number of questionable partnerships that are worth looking into in light of the pandemic.

Most of them are universities, including the University of Alabama, the University of North Texas, and Harvard University. There is also the EcoHealth Alliance, the National Institutes of Health (NIH), and the National Wildlife Federation.

While the relationships between these entities and the Wuhan Institute of Virology may be completely innocent, there is no way to really say for sure without a proper investigation. And this is exactly what Secretary of State Mike Pompeo is calling for, as is the nation of Australia.

Pompeo and the folks down under, along with millions of Americans, would really like to know the true origins of the Wuhan coronavirus (COVID-19). An increasing number of people simply are not buying the narrative that the novel virus originated in bat soup at a Chinese wet market, and this even includes mainstream media outlets like Fox News.

The only way to really determine what was going on at the Wuhan Institute of Virology, and who else might have been involved. is to open the place up for an international investigation. But communist China is against this, of course, accusing Australia of “petty tricks” and collusion with the United States.

“Overnight, I saw comments from the Chinese Foreign Ministry talking about a course of activity with respect to Australia who had the temerity to ask for investigation,” Pompeo is quoted as saying in response to China’s aggression against a proposed investigation.

“Who in the world wouldn’t want an investigation of how this happened to the world?” he added.

As the U.S. aims to get back on track economically speaking, Pompeo believes that now is the time to hold communist China, the Wuhan Institute of Virology, and whoever else may have been involved accountable for unleashing this pandemic on the world.

“Not only American wealth, but the global economy’s devastation as a result of this virus,” Pompeo further stated. “There will be a time for this. We will get that timing right.”

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New U.S. analysis finds that lab in Wuhan, China was “most likely” origin of coronavirus release

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(Natural News) While American Leftists and most of the Democrat Party continue to serve as apologists for the Chinese Communist regime over its role in creating and then perpetuating the coronavirus pandemic, a new U.S. government analysis concludes that COVID-19 “most likely” escaped from a lab near Wuhan city.

The Washington Times reports that the analysis cataloged evidence linking the outbreak to the Wuhan lab and has found that other explanations for the origins of the virus are not as credible.

The paper reported:

The document, compiled from open sources and not a finished product, says there is no smoking gun to blame the virus on either the Wuhan Institute of Virology or the Wuhan branch of the Chinese Center for Disease Control and Prevention, both located in the city where the first outbreaks were reported.

However, “there is circumstantial evidence to suggest such may be the case,” the paper says.

“All other possible places of the virus’ origin have been proven to be highly unlikely,” said the report, a copy of which was obtained by the Times.

ChiCom officials have claimed that the virus’ origin is unknown. However, Beijing initially stated that coronavirus came from animals at a “wet market” in Wuhan where exotic meats are butchered and sold in disgusting conditions.

Chinese officials claim that COVID-19 went from bats to animals sold in the market last year, then infected humans.

U.S. intelligence officials have increasingly dismissed that explanation, however, as attention has begun to focus on evidence suggesting that Chinese medical researchers were working with coronavirus in the country’s only Level 4 facility, which is in Wuhan.

U.S. Army Gen. Mark A. Milley, chairman of the Joint Chiefs of Staff, has said that intelligence agencies are investigating whether the virus escaped from a lab or was the result of a naturally occurring outbreak, but that analysts have ruled out reports that COVID-19 was manmade.

‘The most logical place to investigate the virus origin has been completely sealed off’

“At this point, it’s inconclusive, although the weight of evidence seems to indicate natural,” the general said on April 14, “but we don’t know for certain.”

The analysis said that the wet market explanation does not ring true because the first human diagnosis of coronavirus was made in someone who had no connection to the wet market in question. And according to Chinese reports, no bats were sold at that particular market.

At the same time, several questionable actions and a growing paper trail provide clues that the virus actually escaped from a lab, even as China begins to clamp down on those information streams.

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The biggest media lies about the coronavirus: Origins, treatments and vaccines

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(Natural News) If there is one thing that most everyone can agree on concerning the Wuhan coronavirus (COVID-19) pandemic, it is the fact that there is no shortage of conflicting information out there about the nature of it. And the mainstream media is certainly doing its part to steer the narrative as part of a larger agenda, using plenty of misinformation along the way.

The following are among the most commonly parroted lies about the Wuhan coronavirus (COVID-19) that aim to distort the facts and deceive you into believing falsehoods about this pandemic:

Media LIE: The virus is not man-made

From the very beginning of this thing, the official narrative was that the Wuhan coronavirus (COVID-19) came from a Chinese wet market where bats and other “exotic” animals are sold as meat. But the world later learned that it actually more than likely “escaped” from the Wuhan Institute of Virology.

The mainstream media and social media platforms went nuts trying to censor this information and even called it  “fake news.” But eventually it became undeniable that bat soup was not responsible for spreading the Wuhan coronavirus (COVID-19) around Wuhan and eventually to the rest of the world – hence why we continue to call it the Wuhan coronavirus rather than just COVID-19.

We have even seen attempts by the media machine at making the Wuhan coronavirus (COVID-19) a racial issue because there are supposedly more “people of color” coming down with it than people with fair skin, which further detracts attention away from the source of this virus.

Media LIE: Hydroxychloroquine is extremely dangerous and doesn’t work

The minute that President Donald Trump announced that hydroxychloroquine may be an effective, and very inexpensive, remedy for the Wuhan coronavirus (COVID-19), the mainstream media immediately began decrying this claim as fake news, even though Anthony Fauci himself praised hydroxychloroquine back in 2013 under Barack Obama as being some type of “miracle cure” for SARS (severe acute respiratory syndrome).

There have even been studies conducted that were designed to intentionally smear the drug as both ineffective and dangerous, though one in particular purposely left out zinc, which appears to be a critical co-factor in supporting the effectiveness of hydroxychloroquine – in other words, politics as usual.

Media LIE: Only a vaccine can save us from coronavirus

Many politicians and public health officials are parroting the lie that the only way America can come out of lockdown and go back to “normal” is to get vaccinated with some future vaccine for the Wuhan coronavirus (COVID-19) that does not even yet exist. A vaccine, we are repeatedly told, is the only thing, or perhaps some new “blockbuster” antiviral drug, that can cure the world of this scourge and make everything happy and wonderful once again.

Meanwhile, not a peep is being made about things like intravenous (IV) high-dose vitamin C, which is being successfully used in other countries to stem the tide of infections without the need for new drugs and vaccines.

By omission, nutrition is pointless

Speaking of natural approaches to overcoming the Wuhan coronavirus (COVID-19) that are being systematically ignored by the mainstream media and most in politics, have you heard anyone mention the importance of nutrition in all of this? We did not think so, and this is intentional.

Regular readers of this site over the years should know by now that the single-most important thing you need to do to stay healthy besides exercising regularly is to feed your body the nutrition it needs to naturally ward off illnesses, including those associated with the Wuhan coronavirus (COVID-19).

Research compiled by the Lewin Group reveals that nutritional remedies such as calcium, vitamin D, folate, omega-3 fatty acids, lutein, zeaxanthin, and more all play a critical role in fortifying the immune system, which, if properly nourished, should have little problem fending off disease.

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