In the short time since its April 2012 launch by the American Board of Internal Medicine Foundation, the Choosing Wisely campaign has affected more than 60 US specialty societies. Now the campaign is becoming an international phenomenon, as evidenced by Selby et al1 and Gupta and Detsky2 in this issue. These publications should be considered in the context of other national efforts, the most prominent being Choosing Wisely Canada,3 which identifies itself as being modeled after its American counterpart and having “spread to Australia, Germany, Italy, Japan, Netherlands, Switzerland and elsewhere.” This rapid expansion is a heartening sign that there is increasing international sentiment against wasteful medical practices. However, actually decreasing wasteful and harmful health care will require both patient and physician commitment as well as objective evidence of effectiveness. If either is found wanting, the results will be underwhelming.
Clement F, Charlton B. Challenges in Choosing Wisely’s International FutureSupport, Evidence, and Burnout . JAMA Intern Med. 2015;175(4):644-645. doi:10.1001/jamainternmed.2014.8122