Medical experts emphasize new framework for future efforts to offer specific guidance on right-sizing care

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Sep 15 2020
Medical experts have worked for decades to improve the chances that patients will get the scans, routine tests and medicines that can do them the most good – and avoid the ones that won’t help them at all.

But in the push toward evidence-based medicine, a new study says, a key step has mostly gotten overlooked: helping doctors stop or scale back – or deintensify – treatment once it has started, and take the screening, testing and treatment down a notch as evidence changes or the patient’s health, age and lifestyle change.

To truly help patients, it’s time to include clear off-ramp instructions for providers and patients, especially in primary care, say the authors of a new study published in JAMA Internal Medicine.

They lay out a process for doing so, based on an intensive review of hundreds of recommendations built on reams of research and evidence. Backed by a panel of expert advisors from a wide range of fields, they identify an initial set of 37 specific instances where physicians could deintensify care safely for certain patients.


For many years, we’ve been focused on making sure patients get all the care they need, because there were deficits. But there …

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