Choosing Wisely Canada campaign helps physicians and patients make better decisions together

We live in a highly connected, technology-dependant world. Patients are more informed than ever before, armed with unlimited resources at their fingertips that offer medical advice and treatments for thousands of common ailments. The result is more patients self-diagnosing and requesting unnecessary tests and treatments based on unreliable information.

However, physicians know that unnecessary tests, treatments and procedures do not add value to care. In fact, they potentially expose patients to harm, such as unnecessary exposure to radiation, additional testing to investigate false positive results, preventable stress, and avoidable costs for patients.

That’s why Doctors Nova Scotia partnered with Choosing Wisely Canada, a campaign to help physicians and patients engage in conversations about appropriate tests, treatments and procedures so that together, physicians and patients are making smarter and more effective decisions about appropriate care.

Earlier this year, Doctors Nova Scotia partnered with Capital Health, IWK Health Centre, and the Dalhousie Faculty of Medicine to facilitate a discussion on what Choosing Wisely Canada would look like in Nova Scotia. Doctors Nova Scotia continued this discussion at its annual meeting on May 31 in Halifax.

Dr. James Clarke, radiologist at the QEII, was part of that discussion. His department has been active in this area for a number of years. He believes implementing Choosing Wisely in Nova Scotia is the right thing to do for patients.

“Implementing Choosing Wisely in Nova Scotia will allow for better patient care – not only for those who will avoid unnecessary tests and procedures, but also for all of those Nova Scotians who already have to wait too long to get the care they need,” said Dr. Clarke.

Dr. Sam Campbell is an emergency physician at the QEII Health Science Centre and co-lead on the Choosing Wisely Canada initiative with Capital Health and member of the Choosing Wisely committee of the Canadian Association of Emergency Physicians.

He believes there is tremendous opportunity for the medical community to play a leadership role and to have a positive impact on patient care through the Choosing Wisely Canada campaign.

Currently nine national specialty societies are participating in the campaign, representing a broad spectrum of physicians. They’ve developed lists of “Five Things Physicians and Patients Should Question.” These lists identify tests, treatments or procedures commonly used in each specialty, but are not supported by evidence, and/or could expose patients to unnecessary harm.

From there, a series of best practice guidelines have been developed to help physicians determine the best course of action for patients. For example, Choosing Wisely Canada would not recommend the ordering of diagnostic imaging for lower-back pain of less than six weeks duration unless there are red flags.

These materials not only support the discussions between patients and physicians, but also to arm patients with high-quality, useful and trustworthy information.

“In the Emergency Department we have already begun to review the tests that we typically refer to as ‘routine’, and we have conducted research in the utility of a number of tests that are commonly conducted in the Emergency Department,” said Dr. Campbell.

“I think this campaign reflects an emerging culture change that challenges the status quo and will drastically change the way we think and behave, in terms of ordering medical interventions,” said Dr. Campbell.

Dr. Campbell said he believes Choosing Wisely will make health care better for patients in Nova Scotia, however, it’s still in its early stages in Canada and there is much work left to do.

The nine national medical organizations participating in the first phase of Choosing Wisely Canada are Canadian Cardiovascular Society, Canadian Association of Radiologists, Canadian Medical Association Forum on General and Family Practice Issues, Canadian Orthopaedic Association, Canadian Society of Internal Medicine, Canadian Rheumatology Association, Canadian Geriatrics Society, Canadian Association of General Surgeons, and The College of Family Physicians of Canada.

For more information on Choosing Wisely Canada or to view the lists, visit www.choosingwiselycanada.org.