Choosing Wisely should bring the cost of unnecessary care back into the discussion

Choosing Wisely (CW) identifies low-value, wasteful medical interventions whose elimination increases the quality of care and likely reduces its costs.1 Since its launch in 2012, this grassroot campaign has galvanised many in the medical world. Physicians acknowledge their collective responsibility in reducing overuse, and patient engagement in the campaign suggests times are changing in the medical office.

CW was set up in response to the publication of a charter coauthored by the American Board of Internal Medicine, 'Medical Professionalism in the New Millennium' (2002).2 This physician charter mentioned the principle of 'primacy of patient welfare' along with the commitment to 'a just distribution of finite resources'. Thus, CW would kill two birds with one stone: reduce waste and receive quality and financial sustainability in exchange. However, the CW campaign quickly reached consensus on dropping the cost objective and focusing instead on 'quality and no-harm'. CW...

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