Two Years Down the Road, Choosing Wisely Still Picking Up Steam

FP Touts Campaign's Value During Recent Panel Discussion

May 14, 2014 02:45 pm Chris Crawford

The American Board of Internal Medicine (ABIM) Foundation's Choosing Wisely campaign turned 2 in April. To recognize the initiative's anniversary, the ABIM Foundation released a survey( outlining the progress it has made in encouraging physicians and patients to talk about the need for certain medical tests and procedures.

During a panel discussion marking Choosing Wisely's second year, AAFP member John Barnes, M.D., (center) describes using the campaign's tools. Barnes was joined by Shai Gavi, D.O., (left) chief of hospital medicine at Stony Brook University Medical Center, and Daniel Wolfson, of the American Board of Internal Medicine Foundation.

The results show that although the campaign continues to gain momentum, there is still work to be done.

According to the phone survey of 600 physicians nationwide conducted Feb. 12 through March 21 by PerryUndem Research/Communication, one in five physicians surveyed said they were aware of the Choosing Wisely campaign. Of those, 62 percent said they were less likely to recommend a test or procedure once they learned it was unnecessary.

Additional survey findings include:

  • 73 percent of physicians said the frequency of unnecessary tests and procedures is a very or somewhat serious problem,
  • 72 percent of physicians said the average medical doctor prescribes an unnecessary test or procedure at least once a week, and
  • 70 percent of physicians said that after they speak with a patient about why a test or procedure is unnecessary, the patient often avoids it.
Story highlights
  • To mark the two-year anniversary of the Choosing Wisely campaign, the American Board of Internal Medicine (ABIM) Foundation hosted a panel discussion to release results from a survey of physicians about the campaign.
  • AAFP member and panelist John Barnes, M.D., called the campaign's "5 Questions to Ask Your Doctor Before You Get Any Test, Treatment or Procedure" patient education handout a "game-changing tool."
  • The ABIM Foundation has created new videos explaining the challenges, opportunities and impact of the Choosing Wisely campaign.

Since its inception, 60 medical specialty societies have joined the Choosing Wisely campaign and identified more than 250 tests and procedures that are considered overused or inappropriate, according to a news release(

"Old habits are hard to break, but this research suggests that America’s physicians are slowly making progress in efforts to reduce unnecessary care," said Richard Baron, M.D., president and CEO of the ABIM Foundation, in the release. "Avoiding unnecessary medical care is important because care that is not needed can be harmful to patients, and unnecessary care raises health care costs for everyone.

"Physicians and patients both play roles in reducing the overuse of medical care in America, and this research suggests Choosing Wisely is making a difference."

FP Practices What He Preaches

AAFP member John Barnes, M.D., served on a speaker panel during the May 1 event held to announce the Choosing Wisely survey findings. Not only does he sing the praises of the initiative, he also practices what he preaches in his work as medical director of Winthrop Family Medicine in Winthrop, Maine.

The seven-physician practice has participated in Maine's patient-centered medical home pilot program for the past four years, according to Barnes. In so doing, the group has adopted a team-based model for much of its work, including its efforts to spread the word about Choosing Wisely.

"To bring the clinical content and, more importantly, the '5 Questions to Ask Your Doctor Before You Get Any Test, Treatment, or Procedure'( to the conversation between clinicians and patients, we have used the printed material provided by the ABIM Foundation/Consumer Reports Health in poster form and single-page handouts, in exam rooms, as well as the waiting area, and in staff and provider work areas," Barnes told AAFP News. The "5 Questions" educational resource is the most valuable piece of the Choosing Wisely armamentarium for family physicians, he added, calling it a "game-changing tool."

Choosing Wisely Expands Beyond Physician Groups

On May 1, the American Board of Internal Medicine Foundation announced that its Choosing Wisely campaign will expand for the first time to include nonphysician provider organizations(

Later this year, the American Dental Association, American Physical Therapy Association, and American Academy of Nursing will release lists of tests and procedures that should be reviewed to ensure their appropriateness. Consumer Reports, a partner in the Choosing Wisely campaign, will also work with each organization to develop patient-friendly materials based on their lists.

Clinicians and staff at Winthrop Family Medicine reinforce Choosing Wisely's value and importance by regularly discussing the initiative during group meetings, and the practice's health care professionals and administrative and clinical staff participate in learning sessions about the campaign.

The ultimate goal is to ensure all the practice's clinicians and staff are on the same page when it comes to talking with patients about tests and procedures.

Barnes said that even though the current Choosing Wisely resources are helpful in supporting patient conversations about tests and procedures, the idea of shared decision-making can still be challenging for health care professionals and patients alike. "We will focus our next steps in that direction," he noted.

Overall, Barnes said he is optimistic about realizing the campaign's goal of reducing unnecessary tests and procedures, especially given the many diverse groups taking part in the campaign. "I am amazed at the different perspectives, backgrounds and geographical regions represented," Barnes said. "If there is anything that can change health care, I think that it will be having so many views represented and working together for change."

New Choosing Wisely Videos Posted

The ABIM Foundation has posted a number of new videos explaining the challenges, opportunities and impact of the Choosing Wisely campaign. The latest offerings are

Choosing Wisely: Inspiring Conversations to Reduce Overuse in Health Care.(
Choosing Wisely: Professionalism in Action(
Choosing Wisely in Medical Education(
Strengthening Health Care Through Professionalism(

The full complement of Choosing Wisely videos(, including public service announcements created by Consumer Report's Consumer Health Choices in both English and Spanish, can be accessed online.