Dr. Eric Barbanel, an internist in Middletown, N.Y., is determined to have his patients and their families understand that much of the care they’re used to receiving — including care that he used to deliver himself — turns out to be needless.

Many doctors still offer, and many patients expect, unproductive tests and treatments that may be driven by habit, advertising, outdated training, or financial incentives, he says.

Barbanel credits his change in approach to a nationwide educational campaign, Choosing Wisely. The campaign, launched by the ABIM Foundation, turned four years old this month.

At the core of Choosing Wisely are more than 70 national medical specialty societies that have each named at least five common things they urge their colleagues to reconsider offering because the evidence just doesn’t back them up.

From 45 recommendations when the campaign kicked off in April 2012, the list has grown to more than 450 items that providers and patients should question.

Also growing is the campaign’s influence on care around the country and worldwide. Patients may find themselves in a conversation influenced by Choosing Wisely in Atlanta, San Francisco, Annapolis, or many other medical communities that have embraced the campaign.

Consumer Reports’ contribution to the campaign includes more than 250 brochures, posters, rack cards and wallet cards, which are free for consumers and for like-minded organizations that wish to distribute them to their clients, members, employees, or the public.