COURSE: Practising Wisely - Reducing Unnecessary Testing and Treatment

When I speak to peers and clinicians, one of the most frequent bits of feedback I receive is "Great! I'm on board with delivering more appropriate care, Choosing Wisely, making sure my patients make shared decisions and avoid unnecessary tests and treatments. But... I don't really know how to 'do' it. Where do I start? How to I talk to patients? Where do I go to practice?"

So, it is with extreme pleasure that I announce the expansion of the Practicing Wisely: Reducing Unnecessary Testing and Treatment Course. Originally "Don't just do something, Stand there!," this highly-regarded hands-on learning experience was started by the Ontario College of Family Physicians and is spearheaded by Dr Jennifer Young.

It is now a suite of continuing professional development opportunities for primary care providers, available in a modular format across the country. In the course: 

Participants will identify opportunities to "practise wisely", with a focus on reducing over-prescribing, over-imaging, over-screening and over-monitoring using the latest evidence and tools from diverse sources. This workshop aligns closely with the Choosing Wisely Canada (CWC) campaign to implement good healthcare stewardship and avoid over-medicalization.

The program centres on case studies and incorporates individual reflection and group work. It helps participants to build communication skills to guide their patients through the shift from seeking sickness to enhancing health.


After active engagement in this program, participants will be better able to:

  • Identify opportunities to reduce “too much medicine”
  • Access and assess reliable, renewing online resources
  • Integrate relevant evidence into individual patient care
  • Communicate and build consensus with patients to reduce over-medicalization

    Upcoming Workshops are taking place as follows:

    May 24/17 - Montreal
    May 29/17 - Ottawa
    June 3/17 - Newfoundland
    Nov 22/17 - Toronto

    Find out more about the Practising Wisely program by viewing the main website or reading through this Q&A with Course Director, Dr. Jennifer Young.

    Source: http://ocfp.on.ca/cpd/practising-wisely

    VIDEO: Good Stewardship / Model conversations with patients about overtesting and overtreatment

    The National Physician Alliance (NPA) has done a lot of work in the area of preventing overdiagnosis and empowering patients to find the right amount of care. They are a partner in the Tandem Health project/app, created Top 5 lists (in good stewardship) which served as a model for the Choosing Wisely Campaign, and promote responsible prescribing (by limiting influence of the pharmaceutical industru) through The Unbranded Doctor.

    Created in 2011, this video is a timeless tool for Good Stewardship. It gives a simple, 5-step plan of how health care providers can discuss unnecessary tests and treatments with patients.

    They suggest:

    1. Clarify what the patient’s true concerns are
    2. Provide the patient with the information he/she needs to understand the plan
    3. Be courteous and respectful
    4. Provide clear contingency plan
    5. Make sure the patient is satisfied with the plan
    Source: https://www.youtube.com/watch?v=kh7EKP9wSg...

    Choosing Wisely Canada extra resources

    Being part of the Early Adopters collaborative for Choosing Wisely Canada, I've been made aware of some really useful resources that you may not have heard of yet.

    Thanks to Tai Huynh (Campaign Manager) and Karen McDonald (Project Manager) with Choosing Wisely Canada for allowing me to share their commentary and these great links:

    1.     Canadianized patient pamphlets

    In collaboration with Consumer Reports Health and Canadian medical specialty societies participating in Choosing Wisely Canada, we have (to date) released 25 lay language patient pamphlets to help educate patients and facilitate provider-patient conversation on tests, treatments and procedures that may not be necessary. These pamphlets can be found in the materials section of the Choosing Wisely Canada website  and are downloadable as PDFs. The generic patient pamphlet contains four questions patients are encouraged to ask their doctors.

     2.     Instructional videos to help providers and patients think and talk about overuse

    The ABIM Foundation funded the Drexel University College of Medicine to develop a set of interactive instructional modules to enhance physician and patient communication around the specialty society recommendations from the Choosing Wisely campaign. Developed in collaboration with nine medical specialty societies, these modules are designed to help physicians, patients and other health care stakeholders think and talk about overuse of health care resources by providing strategies for physicians to build trust and address patient attitudes and beliefs that more care is not always better care.

    These videos can be accessed from the US Choosing Wisely website, modules section. They are a bit tricky to locate, so here are some examples: 

    3.     Washington State Choosing Wisely Task Force toolkit

    A PDF of the Washington State toolkit created for physicians or other health care leaders struggling with how to integrate Choosing Wisely’s evidence based best practices into their practices or organizations.

    4.     Spreadsheet of Canadian physician recommendations

    A spreadsheet containing all 102 CWC recommendations released to date is attached and can be downloaded from our website http://www.choosingwiselycanada.org/recommendations/