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71 FINANCE CMO / CARE DELIVERY 10 Most Overused Medical Tests, Treatments By Alyssa Rege P hysicians and healthcare practitioners continue to overuse and overpre- scribe various medical tests and treatments, according to an Oct. 2 study published in JAMA. For the study, researchers ana- lyzed original research articles published in 2016 that sought to understand and curb medi- cal overuse. The research team collected 2,252 papers, 1,224 of which directly addressed the overuse of medicine in instanc- es where "potential harms out- weigh potential benefits." Researchers collectively whit- tled the number of significant papers to 10, according to Sci- entific Alert. Here are the 10 most overused medical tests and treatments. 1. Transesophageal echocardi- ography 2. Computed tomography pul- monary angiography 3. Computed tomography in patients with respiratory symp- toms 4. Carotid artery ultrasonogra- phy and stenting 5. Aggressive management of prostate cancer 6. Supplemental oxygen for pa- tients with chronic obstructive pulmonary disease 7. Surgery for meniscal cartilage tears 8. Nutritional support in medi- cal inpatients 9. Use of antibiotics 10. Use of cardiac imaging n CVS Is Now Limiting Opioid Prescriptions By Brian Zimmerman A s part of several new measures to curb the rate of opioid addiction and over- doses, CVS Health is enacting seven-day opioid prescription limitations for acute conditions, the company announced Sep. 21. The prescription limits will be carried out by the company's prescription drug man- agement division, CVS Caremark. In addition to the seven-day cap for acute pre- scriptions, CVS Caremark will limit the daily dose of opioids dispensed based on the strength of the opioid and initially require patients to use immediate-release opioids for pain before moving to extended-release formulations. If pharmacists encounter a prescription that is not in accordance with these guide- lines, they will contact the physician and ask him or her to revise the prescription. Larry Merlo, CEO of CVS, told USA Today the pharmacy often encounters 30- to 60- day prescriptions for high potency opioids. "We see that all too often in the marketplace and we believe it's appropriate to limit those prescriptions to a much more moderate and appropriate supply," said Mr. Mer- lo. "We think this can help make an impact." The move from CVS comes as physicians, drugmakers, drug wholesalers and insur- ers feel growing pressure to address the crisis. In regards to the possible role of these separate entities in facilitating the crisis, Mr. Merlo told USA Today, "From my perspective, it's not a blame game at this point … I think as healthcare stakeholders we all play an important role in being part of the solution." Additional measures announced by CVS Sep. 21 to address the crisis include in- stalling in-store medication disposal units, donating additional funds for addiction treatment and expanding opioid abuse education. n Study Finds Physician Satisfaction Not Associated With Better Quality Care By Emily Rappleye A lthough high levels of job satisfaction can improve burnout and retention rates, enjoying the practice of medicine does not appear to be correlated to better quality care or fewer medical errors, according to a study published in Health Affairs. Researchers measured job satisfaction as well as patient and clinician outcomes at a baseline and again one year later. ey polled 168 clinicians across 34 medical practices. In the baseline year, 74 percent of clinicians reported joy in practice. Satisfied clinicians were associated with less chaotic work envi- ronments, more cohesive workplace culture, better communication, greater trust and greater align- ment of values between leadership and employees, according to the study. Satisfaction at the baseline was associated with lower stress and burnout, and less desire to leave the group or practice. A year later, those who reported improved job satisfaction were found to be nearly three times less likely to report burnout and more than eight times as likely to report intentions to stick with the job. e study was conducted from 2011-14. However, researchers noted no changes in care quality or frequency of medical errors. ey suggest improved job satisfaction and retention over a period of time longer than the study could lead to better care coordination and therefore better outcomes. "Improvements in quality and errors may take longer or stronger interventions," the study authors wrote. "[C]linician satisfaction may be more important in terms of morale, loyalty to the organiza- tion, and reductions in turnover than in terms of direct improvements in patient satisfaction and other patient outcomes." n