Physicians and patients should talk about unnecessary medical tests, treatments and procedures so that they can make smart and effective care choices and avoid potential for harm, writes Dr. Wendy Levinson in a commentary in CMAJ (Canadian Medical Association Journal).

Choosing Wisely Canada is a new campaign designed to encourage awareness and discussion between doctors and patients about unnecessary tests, procedures and treatments. Choosing Wisely was launched in the United States in February 2012. Sixty medical societies are participating, and many have released lists of "Five Things Physicians and Patients Should Question." Each of the "five things" is a statement beginning with the word "Don't" or "Avoid" (i.e., "Don't do imaging for low back pain within the first six weeks, unless red flags are present"). Choosing Wisely Canada is modelled on the US campaign; however, Canadian societies will create lists tailored to Canada. The goal of the campaign is to improve patient care. Eight Canadian societies will release their lists in April 2014.

"Physicians must lead the effort to ensure that precious health care resources are used wisely," writes Dr. Wendy Levinson, from Choosing Wisely Canada and the University of Toronto, with coauthor Tai Huynh, campaign manager, Choosing Wisely Canada.

"Every test, treatment and procedure physicians order must be evidence-based, have potential to add value and minimize potential harm to patients. For many years, both physicians and patients have had a "more is better" attitude. It is time to adopt a "think twice" attitude and to avoid unnecessary and potentially harmful tests, procedures and treatments."