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Choosing Wisely

By H. Andrew Selinger M.D.

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In healthcare, one can argue that the most important relationship is between a clinician and a patient. This relationship between a clinician and a patient should be rooted in trust and should benefit the patient. It is important that the clinician and patient continually communicate with one another to ensure the best, high-quality care for the patient. With this idea in mind, the Choosing Wisely® initiative was created.

Choosing Wisely® is a campaign meant to promote conversations between clinicians and patients to help patients choose or ask for care that is supported by evidence, not duplicative of other tests or procedures already received, free from harm and truly necessary.

This initiative came to be because of Dr. Howard Brody. In 2010, Dr. Brody asked medical specialty societies to share a list of five tests and treatments that were overused in their practices and weren’t a benefit to the patient. This list gained media coverage and resulted in the creation of the Choosing Wisely® campaign to help clinicians and patients engage in conversations to reduce unnecessary testing and treatments and to use healthcare resources effectively.

Patient perception is important. One survey conducted by SHARP Consumer Research found that “75% of people agreed that patients can be harmed if they get medical treatments or services that are not needed.” This survey also quoted some survey responses of those who think a conversation between a clinician and patient is important. For example, one respondent stated, “I believe that any health care treatment should always be a balance between both the physicians’ knowledge/experience and what the patient knows and feels.” This research showcases that Choosing Wisely® is an initiative that can help patients and be the best platform to address patient perceptions in an informed manner.

One goal of Choosing Wisely® is to promote patient-centered healthcare. What that means is the care should revolve around the patient and benefit the patient. Choosing Wisely® does this through shared decision making. The conversation between clinicians and patients allows for a shared decision-making process to take place where the two work together to decide what tests, treatments, and care plans to investigate based on clinical evidence and if it is truly necessary and free from harm.

This shared-decision making process to ensure patient-centered healthcare is taught to medical school students and new physician residents. They are taught about essential steps of shared decision making through the SHARE approach:

  • Step one: Seek patients’ participation
  • Step two: Help patient explore & compare treatment options
  • Step three: Assess the patients’ values and preferences
  • Step four: Reach a decision with the patient
  • Step five: Evaluate the patients’ decision

To further ensure that care is patient-centered, the Choosing Wisely® campaign put together 5 questions that patients should ask their doctors before receiving any tests, treatments or procedures that will aid the patient in ensuring that they receive the right care.

To further understand the Choosing Wisely® initiative more clearly please watch this YouTube video.

The Choosing Wisely® initiative has many other resources for patients to download and use at their next doctor’s appointment to ensure the best care and to be a part of the decision-making process, including:

Please be assured that your clinician wants to recommend and provide to you the best possible healthcare. Choosing Wisely® permits them to do just that.

Written by H. Andrew Selinger M.D.

Additional Resources:
Choosing Wisely® Survey exploring patient and physician conversations and trust
Choosing Wisely® Mission
Choosing Wisely® History

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