[Less is more… in the general practitioner's internistic surgery : Subclinical hypothyroidism, hyperuricemia, routine ECG and NT-proBNP as selected examples].

Exceeding the need for care in general practitioner (GP) practices is a known problem that affects the work of approximately 16,000 specialists for internal medicine in the family practice context every day in Germany. In order to spare patients unnecessary treatment and measures, these must be critically questioned on a regular basis. Subclinical hypothyroidism (SH) and hyperuricemia (HU) are frequent laboratory constellations. The selected articles by Stott et al., de Montmollin et al. and Mooijaart et al. could show that treatment of SH in older patients is not effective. Furthermore, according to the studies of Li et al. and Badve et al. treatment of HU is only beneficial in the treatment of gout and nephrolithiasis and has no influence on the development of chronic kidney disease. The Canadian group of Bhatia demonstrated that the ECG for low-risk patients that is often part of health check-ups in Canada, usually results in more follow-up examinations without the groups with and without ECG differing with respect to major adverse cardiac events (MACE). Laboratory chemical analysis of N‑terminal prohormone of brain natriuretic peptide (NT-proBNP) for managing the treatment of heart failure is also not more effective than traditional treatment methods according to Felker et al., therefore, it can be discarded. "Choosing wisely", "Less is more" and the "Klug entscheiden (Smart decisions)" recommendations by the German Society for Internal Medicine are initiatives that make the process of avoiding overprovision of care accessible for all practitioners in a short and concise form.