IF PATIENTS AREN'T PAYING FOR IT THEY WON'T CARE WHAT IT COSTS:

The patient suffers from headaches and wants to undergo the dull roar of an MRI machine to make sure everything is all right. Good idea?

Probably not.

How about the drip-drip of chemo for the cancer patient who is near death? A CT scan for someone who has fainted but shows no neurological symptoms? Or an annual electrocardiogram for a person with low risk of heart disease?

No, no and no.

These are among dozens of recommendations that nine medical societies are announcing Wednesday, in an effort led by the ABIM Foundation, an affiliate of the American Board of Internal Medicine, based in Philadelphia.

With governments and insurers bemoaning the soaring costs of health care, the medical profession is increasingly offering its own solutions. The new campaign, dubbed Choosing Wisely, is not the first such effort but is among the most comprehensive.

Now comes the tricky part: getting patients and doctors to go along with it.

Various estimates have pegged spending on unnecessary tests at $200 billion to $250 billion each year in the United States, a phenomenon blamed on such factors as overcautious doctors who seek to avoid malpractice claims and patients who don't realize how much their treatments cost.

Organizers of Choosing Wisely say the goal is not cutting costs, strictly speaking, but achieving the best value and the best care. If an expensive test is necessary, then full steam ahead. Conversely, some tests are cheap but still should not be done because they can subject the patient to needless anxiety and risky follow-up procedures that turn out to be unnecessary, the groups say.

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