Choosing Wisely
[1] The campaign identifies over 500 tests and procedures and encourages doctors and patients to discuss, research, and possibly get second opinions, before proceeding with them.
[2] To conduct the campaign, the ABIM Foundation asks medical specialty societies to make five to ten recommendations for preventing overuse of a treatment in their field.
[15] They can be searched online by key words, such as "back pain" but the numerous supporting footnotes on each recommendation are only in a pdf on the clinician page, without links to the papers.
Some examples of the information shared in Choosing Wisely include the following: The Choosing Wisely campaign identifies the following difficulties in achieving its goals: The American College of Emergency Physicians (ACEP) initially formed three independent task forces to evaluate whether to participate; by 2012 all three task forces recommended against participation because the recommendations do not recognize that emergency physicians need extra tests, since they do not know the patients, do not recognize that emergency physicians need to eliminate every life-threatening possibility, will lead to refusals by insurers to cover items on the lists, let other medical societies tell emergency physicians what to do, and because the campaign does not address tort reform to address defensive testing, and the campaign publicizes the items as "unnecessary tests" even though describing them as tests to discuss carefully.
[24] In 2012 The New York Times said that the campaign was likely to "alter treatment standards in hospitals and doctors' offices nationwide" and one of their opinion writers said that many tests were unnecessary.
[28] In an editorial published in the Southwest Journal of Pulmonary and Critical Care, Richard Robbin and Allen Thomas expressed concern that the campaign could be used by payers to limit options for doctors and patients.
"[29] Also in 2012, Robert Goldberg, writing for The American Spectator, criticized the program saying that it was "designed to sustain the rationale and ideology that shaped Obamacare" (the Patient Protection and Affordable Care Act), that the lists were "redundant and highly subjective", and that participants in the effort would greedily benefit at the expense of others if the campaign succeeded.
"[33] In 2015 the campaign was criticized by Bob Lanier, executive director of a medical specialty society and past president of the Texas Medical Association Foundation, who said that the recommendations were compiled by societies' executive committees without good evidence and without following standards of practice or research, will lead to refusals by insurers to cover items on the lists, are biased against diagnostic testing, are an effort by supporters of single-payer healthcare to reduce costs so that single-payer healthcare becomes affordable, will encourage biased studies by authors funded by insurers and health delivery systems, to cut their costs, and were influenced by grants available from the ABIM Foundation.
[13] In 2015 a piece in Newsweek by Kurt Eichenwald described a controversy around the ABIM Foundation's lack of transparency about its finances and functioning.
Barriers "included malpractice concern, patient requests for services, lack of time for shared decision making, and the number of tests recommended by specialists.
[43] Choosing Wisely Canada is organized by the Canadian Medical Association and the University of Toronto, and is chaired by Dr. Wendy Levinson.
