About the Choosing Wisely campaign
Recognizing that patients sometimes ask for tests and treatments that are not necessarily in their best interest, and that physicians often struggle with decisions about prescribing tests and procedures as a way of covering all possible bases, the ABIM Foundation has joined with leading medical specialty societies to develop evidence-based lists of tests and procedures for patients and physicians to question as part of Choosing Wisely®. The goal of this campaign is to help physicians, patients and other health care stakeholders think and talk about overuse of health care resources in the United States. The campaign is part of the ABIM Foundation’s goal of promoting wise choices by clinicians in order to improve health care outcomes, provide patient-centered care that avoids unnecessary and even harmful interventions, and reduce the rapidly-expanding costs of the health care system.
Consumer Reports has joined the Choosing Wisely® campaign to provide resources for consumers and physicians to engage in these important conversations about the overuse or misuse of medical tests and procedures that provide little benefit and in some cases harm. Consumer Reports is excited to be able to reach millions of consumers with important health care information in its role as the “consumer communicator” in the campaign.
First launched with the contributions of nine medical societies in April 2012, the campaign was joined by more than a dozen additional societies in February 2013, each with their own lists of tests and procedures that physicians and patients should question.
Here is a single PDF containing the complete list of Choosing Wisely recommendations.
Choosing Wisely campaign materials
Consumer Reports is creating consumer resources based on many of the Choosing Wisely topics. The titles below connect to our growing catalog of brochures and videos.
- If you don’t have symptoms or a medical evaluation that points to allergy, think twice about skin or blood tests.
- If you're having memory problems, your doctor should look for other causes before ordering a brain scan.
- Antibiotic eye drops or ointments don’t usually help with conjunctivitis. In fact, they can do more harm than good.
- Most of the time, children don't need antibiotics for sore throat, cough or runny nose.
- Many older people get antibiotic treatment for urinary tract infections when they don't need it.
- Powerful antipsychotic drugs should not be the first choice for people with dementia. Here's why.
- If you’re not at higher risk for weak bones, you should think twice about the bone-density test. Here’s why.
- Some tests, treatments, and procedures are not only unnecessary, they can even prove harmful.
- Although it is hard to accept, the best thing for you may be to stop treatment for the cancer.
- In some cases, especially in healthy people without chest pain, you should be cautious about the tests.
- Having some blockage in a carotid artery doesn't automatically mean you should have artery-clearing surgery.
- If you don’t have signs or symptoms of heart or lung disease, think twice about having a pre-operative X-ray.
- Even a very good test can be done too often.
- Think twice about treating migraine attacks with opioids or butalbital.
- The older, "non-biologic" drugs are a better first choice for treating rheumatoid arthritis.
- When do you need CSFs? When don't you need them?
- To hurry a baby’s birth can increase the risk of serious problems for both you and your baby.
- If you’re having surgery, you may wonder if you need an echocardiogram first.
- When do you need an echocardiogram?
- Sometimes the echocardiogram imaging test is done very soon after heart valve surgery, while you are still in the hospital. Usually that's not useful.
- EKGs or exercise stress tests usually aren't necessary for people without symptoms.
- Feeding tubes sometimes do more harm than good. Here’s why.
- If you’re having surgery, you may wonder if you need a heart imaging test first to make sure it is safe.
- Stress tests usually aren’t helpful if you don’t have heart problems.
- If you don't have heart problems, you probably don't need a heart test before an operation.
- When do cancer experts recommend imaging tests and tumor marker tests?
- If you’ve had bypass surgery or a stent inserted to open a blocked artery, do you need regular imaging tests?
- It seems like getting an X-ray, CT scan or MRI to find the cause would be a good idea.
- It's not always a good idea to get all the tests that are available. You may not need them.
- Many with severe headaches want a CT scan or MRI to see if they have a tumor or other serious problem.
- If you are a healthy person without symptoms, you should think twice about having these tests.
- Repetitive ultrasound exams may not be necessary.
- Some people receive the treatment even though they don’t need it.
- An ICD helps the heart beat normally. But if you are near death, those shocks can make things worse.
- Here are four important tests and treatments you should carefully discuss with your family and doctor
- Most healthy people don't need blood or urine tests done before surgery, especially low-risk surgery. Here's why.
- There are two blood tests for Lyme disease, but usually you don't need them. Here's why.
- Most people don't need to have their blood tested or their heart checked before they have eye surgery. Here's why.
- Sometimes antibiotic eardrops are safer and more effective than oral antibiotics.
- If you suffer from high blood pressure, heart failure, or kidney disease, steer clear of some pain relievers.
- Many teenage girls and some women have the test when they don’t need it. Here’s why.
- Older adults usually should try other non-drug treatments first, for insomnia and anxiety.
- Many people who need the test don’t receive it.
- Unless you're experiencing symptoms, this test usually isn't helpful in the first few years after heart bypass surgery or a stent procedure.
- If you’re having surgery, you will probably not need a heart stress test beforehand if you are healthy, active, and feeling well, or if you’re having minor surgery.
- If you’re at low risk for having a heart problem, even if you have symptoms, you usually don’t need this imaging test.
- Unless you have other symptoms of low testosterone, you should think twice about the treatment. Here's why.
- Before heart surgery, you probably don't need a breathing test or carotid ultrasound test, unless you have breathing problems or symptoms.
- Most people with Peripheral Artery Disease won't benefit from surgery or angioplasty.
- In most cases of heartburn a PPI isn't necessary.
- Millions of people are prescribed antibiotics each year for sinusitis.
- Millions of people are prescribed antibiotics each year for sinusitis.
- A guide to common tests and treatments you probably don't need.
Physician organizations participating in Choosing Wisely® include:
- American Academy of Allergy, Asthma & Immunology
- American Academy of Clinical Toxicology
- American Academy of Dermatology
- American Academy of Family Physicians
- American Academy of Hospice and Palliative Medicine
- American Academy of Neurology
- American Academy of Ophthalmology
- American Academy of Orthopaedic Surgeons
- American Academy of Otolaryngology–Head and Neck Surgery
- American Academy of Pediatrics
- American Association of Blood Banks
- American Association of Clinical Endocrinologists
- American Association of Neurological Surgeons
- American Association for Pediatric Ophthalmology and Strabismus
- American College of Cardiology
- American College of Chest Physicians
- American College of Emergency Physicians
- American College of Medical Toxicology
- American College of Obstetricians and Gynecologists
- American College of Occupational and Environmental Medicine
- American College of Physicians
- American College of Radiology
- American College of Rheumatology
- American College of Surgeons
- American Gastroenterological Association
- American Geriatrics Society
- American Headache Society
- AMDA—Dedicated to Long Term Care Medicine
- American Psychiatric Association
- American Society of Anesthesiologists
- American Society of Clinical Oncology
- American Society for Clinical Pathology
- American Society of Colon and Rectal Surgeons
- American Society of Echocardiography
- American Society of Hematology
- American Society of Nephrology
- American Society of Nuclear Cardiology
- American Society of Plastic Surgeons
- American Society for Radiation Oncology
- American Society for Reproductive Medicine
- American Thoracic Society
- American Urological Association
- Commission on Cancer
- The Endocrine Society
- Heart Rhythm Society
- National Physicians Alliance
- North American Spine Society
- Society for Cardiovascular Angiography and Interventions
- Society of Cardiovascular Computed Tomography
- Society for Cardiovascular Magnetic Resonance
- Society of Critical Care Medicine
- Society of General Internal Medicine
- Society of Gynecologic Oncology
- Society of Hospital Medicine
- Society for Maternal-Fetal Medicine
- Society of Nuclear Medicine and Molecular Imaging
- Society of Thoracic Surgeons
- Society for Vascular Medicine
Here is the full updated list of specialty medical society partners.
As part of Choosing Wisely®, each participating specialty society has identified its own list of five common tests or procedures whose use in their profession should be discussed or questioned. The societies were given the following parameters to develop the lists:
- Each item should be within the specialty’s purview and control;
- Procedures should be used frequently and/or carry a significant cost; and
- There needs to be evidence to support each recommendation.
Consumer Reports then is creating consumer education materials for each item, intended for patients and their families.
Our partners are organizations that have discussed methods of content development, assisted in dissemination strategies, or have set up distribution campaigns in coordination with Consumer Health Choices.
AARP is a nonprofit, nonpartisan organization with a membership that helps people 50+ have independence, choice and control in ways that are beneficial and affordable to them and society as a whole.
Alliance Health Networks
Alliance Health Networks is an innovative social networking company whose mission is to enable a more consumer-centric health-care industry. With a growing portfolio of social networks built around distinct disease states and health interests, Alliance Health today connects more than one million registered members across 50 different conditions. Alliance Health’s platform unlocks meaningful opportunities for patients and caregivers to connect with each other, to personalized information, and to products and services.
Midwest Business Group on Health
The Midwest Business Group on Health is a non-profit, Chicago-based business coalition comprised primarily of human resources and health benefits professionals from over 100 large, self-insured public and private employers as well as other health care stakeholders. Members represent over 3 million lives and spend more than $3 billion on health care benefits on an annual basis. MBGH serves as one of the nation’s leading employer-focused coalitions and is a recognized leader in offering education, research and community-based activities that increase the value of health benefits and health care services.
National Business Coalition on Health
The National Business Coalition on Health is a national, non-profit, membership organization of purchaser-led health care coalitions. NBCH and its members are dedicated to value-based purchasing of health care services through the collective action of public and private purchasers. NBCH seeks to accelerate the nation’s progress towards safe, efficient, high-quality health care and the improved health status of the American population.
National Business Group on Health
The National Business Group on Health is the nation’s only nonprofit organization devoted exclusively to representing large employers’ perspective on national health policy issues and providing practical solutions to its members’ most important health care and health benefits challenges. Business Group members are primarily Fortune 500 companies and large public-sector employers—representing the nation’s most innovative health-care purchasers—that provide health coverage for more than 55 million U.S. workers, retirees and their families. The Business Group fosters the development of a safe, high-quality health-care delivery system and treatments based on scientific evidence of effectiveness. Business Group members share strategies for controlling health care costs, improving patient safety and quality of care, increasing productivity, and supporting healthy lifestyles.
National Center for Farmworker Health
The National Center for Farmworker Health (NCFH), established in 1975, is dedicated to improving the health status of farmworker families by providing technical assistance, information services and provider and patient education products to a network of 700+ migrant health center service sites in the United State as well as academic institutions, researchers, and individuals involved in farmworker health.
National Partnership for Women & Families
The National Partnership for Women & Families is a non-profit, non-partisan advocacy group dedicated to promoting fairness in the workplace, access to quality health care and policies that help women and men meet the dual demands of work and family. The organization has fought for every major policy advance that has helped women and families over the last 40 years. The National Partnership runs the Campaign for Better Care, a multi-faceted national effort to protect vulnerable older patients with multiple health problems and ensure they can access well-coordinated, quality health care. The Campaign has built a broad-based consumer coalition with more than 150 organizations, and has mobilized tens of thousands of online activists across the country to advance this work. It is funded by The Atlantic Philanthropies.
Pacific Business Group on Health
Pacific Business Group on Health is one of the nation’s leading non-profit business coalitions focused on health care. PBGH helps leverage the power of its 50 large purchaser members who spend 12 billion dollars annually to provide health care coverage to more than 3 million employees, retirees and dependents in California alone. PBGH works on many fronts to improve the quality and affordability of health care,often in close partnership with health insurance plans, physician groups, consumer organizations, and others concerned about the health care system.
SEIU is the fastest-growing union in North America. Focused on uniting workers in three sectors to improve their lives and the services they provide, SEIU is the largest health-care union, with more than 1.1 million members in the field; the largest property services union, with 225,000 members in the building cleaning and security industries; and the second largest public services union, with more than 1 million local and state government workers.
The Leapfrog Group
The Leapfrog Group is a coalition of public and private purchasers of employee health benefits founded over ten years ago to work for improvements in health-care safety, quality, and affordability. Leapfrog conducts the annual Leapfrog Hospital Survey, the gold standard for comparing hospitals’ performance on the national standards of safety, quality, and efficiency that are most relevant to consumers and purchasers of care.
In just over a decade, Wikipedia has become the world’s largest, most widely-read general information resource. Its success is built on a dedication to clear, factual, neutral information, and a novel production process that permits any individual to play a role in fighting bias. Wikipedia’s 90,000 active contributors have applied the collaborative practices pioneered in free/open source software development to the world of knowledge production and public education. Wikipedia’s non-profit, volunteer-driven model, unique among the world’s top 25 web sites, empowers citizens and consumers with knowledge and with the ability to contribute directly to a world-class publication. Wikipedia volunteers specializing in health and medicine will work closely with the medical experts of Choosing Wisely, building on each other’s skills to inform consumers about over-prescribed medical procedures. Choosing Wisely worked with Wiki Strategies consulting agency to recruit a Wikipedian in Residence, based on successful programs at the British Museum, the U.S. National Archives, and the Children’s Museum of Indianapolis. This Wikipedia expert will connect Choosing Wisely with the dedicated volunteer community that has produced 23,000 medical articles on Wikipedia.
National partners and specialty societies
National Hospice and Palliative Care Organization
The National Hospice and Palliative Care Organization (NHPCO) is the largest leadership and membership organization representing hospice and palliative care programs and professionals in the United States. The organization is committed to improving end-of-life care and expanding access to hospice and palliative care with the goal of profoundly enhancing quality of life for people dying in America and their loved ones. NHPCO’s innovative programs include Caring Connections, a national consumer and community engagement initiative to improve care at the end of life. Caring Connections provides free resources and information to help people make decisions about end-of-life care and services before a crisis and brings together community, state and national partners working to improve care.
Union Plus is brought to you by Union Privilege, established by the AFL-CIO in 1986 to deliver Union Plus consumer benefit programs uniquely designed for working families. Union Plus benefits are exclusively for participating union members, retirees and their families. Union Plus uses the collective buying power of more than 13 million union members to offer over 40 discounts and services to working families.
California was the first state to create a health benefit exchange following the passage of the federal health care law. Covered California is charged with creating a new insurance marketplace, in which individuals and small businesses can get access to health insurance. With coverage starting in 2014, Covered California will help individuals compare and choose a health plan that works best for their health needs and budget. Financial help will be available from the federal government to help lower costs for people who qualify on a sliding scale. Small businesses will be able to purchase competitively priced health plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits. Covered California is an independent part of state government whose job is to make the new market work for California’s consumers. It is overseen by a five-member board appointed by the governor and legislature. For more information on Covered California, please visit www.CoveredCA.com.
Minnesota Health Action Group
The Minnesota Health Action Group is a not-for-profit coalition of public and private employers committed to reshaping Minnesota’s health-care landscape by introducing innovative programs and solutions that address cost, quality, outcomes, and access for health-care purchasers; convening leaders from private and public-sector business, health care suppliers, and government to find solutions to health-care challenges while building Minnesota communities (and ultimately, a healthy workforce); and engaging health-care consumers so they better manage their health and begin to purchase health-care services based on cost and quality data. Established in 1988 as the Buyers Health Care Action Group, the organization has served as a catalyst for the development of new models of care delivery, aligned payment strategies and consumer engagement.
Oregon Health Care Quality Corporation
The Oregon Health Care Quality Corporation is an independent, nonprofit organization dedicated to improving the quality and affordability of health care in Oregon by leading community collaborations and producing unbiased information. Q Corp works with community members – including consumers, providers, employers, policymakers and health insurers – to improve the health of all Oregonians. For more information, visit www.Q-Corp.org.
Puget Sound Health Alliance
The Puget Sound Health Alliance is a nonprofit organization where the people who get, provide and pay for health care come together to improve health care quality and affordability in a five-county region in Washington State. Alliance participants include employers, physicians, hospitals, patients, health plans, and others from throughout the region. The alliance measures the quality of health care and produce publicly available reports designed to help improve health care decision-making.
Washington State Medical Association
The Washington State Medical Association represents over 9,800 physicians throughout Washington state. Its vision is to make Washington state the best place to practice medicine and to receive care. The WSMA is promoting Choosing Wisely as part of its Know Your Choices – Ask Your Doctor campaign, a statewide effort to give patients the tools they need to make informed choices about their care — whether that’s a CT scan for a headache, understanding choices other than the emergency room when unexpected care is needed, or making informed end-of-life choices. For more information about the WSMA, please visit www.wsma.org.