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January 9, 2015

Study: Doctors pounding too hard on tests for headaches

The financial costs of treating Americans for headaches could be offset if physicians focused more on counseling about lifestyle changes and ordered fewer tests, according to a study released Thursday.

Researchers at Beth Israel Deaconess Medical Center, who examined more than 9,000 physician visits associated with headache complaints from 1999 to 2010, concluded that "rather than talking to patients about the causes and potential sources of relief from headache pain, clinicians are increasing ordering advanced imaging and providing specialist referrals, both of which are considered to be of little value in the treatment of routine headaches."

Lead study author Dr. John Mafi noted guidelines for routine headaches from the American Academy of Neurology suggest conservative treatments such as stress reduction counseling and "avoiding dietary triggers."

The study suggests the "20-minute visit-based model of healthcare is broken" and there needs to be a movement towards using technology so patients and doctors can collaborate outside of the office visit, Mafi said. The study found a decline in physician counseling over the 11-year period and "persistent overuse" of advanced imaging services as well as prescriptions for opioids and barbiturates.

In a statement, Mafi said, "I was particularly alarmed about the overall trend of more imaging tests, medications, and referrals alongside less counseling. These findings seem to reflect a larger trend in the US healthcare system beyond just headache: over-hurried doctors seem to be spending less time connecting with their patients and more time ordering tests and treatments."

Researchers estimated 12 million Americans visit doctors each year complaining of headaches, resulting in lost productivity and costs of about $31 billion.

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