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Invited Commentary
April 2015

Challenges in Choosing Wisely’s International Future: Support, Evidence, and Burnout

Author Affiliations
  • 1Department of Community Health Sciences, O’Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada
  • 2Department of Internal Medicine, University of California, San Francisco
JAMA Intern Med. 2015;175(4):644-645. doi:10.1001/jamainternmed.2014.8122

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.

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    1 Comment for this article
    need for rigorous studies?
    Mark McConnell, MD | independent
    Do we really need rigorous studies on outcomes of reducing use of diagnostic or therapeutics considered to be of no value? Most of these identified diagnostic and therapeutic interventions were implemented without rigorous studies that they actually had value.
    CONFLICT OF INTEREST: None Reported
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