What Is CWC?

Choosing Wisely Canada (CWC) is a campaign to help clinicians and patients engage in conversations about unnecessary tests and treatments and make smart and effective choices to ensure high-quality care.

Unnecessary tests and treatments do not add value to care. In fact, they take away from care by potentially exposing patients to harm, leading to more testing to investigate false positives and contributing to stress for patients. And of course unnecessary tests and treatments put increased strain on the resources of our health care system.

Canadian national specialty societies participating in the campaign, representing a broad spectrum of clinicians, have been asked to develop lists of “Five Things Clinicians and Patients Should Question.” These lists identify tests and treatments commonly used in each specialty, but are not supported by evidence, and/or could expose patients to unnecessary harm.

Choosing Wisely Canada is modeled after the Choosing Wisely® campaign in the United States, which was launched by the ABIM Foundation in April 2012.

Choosing Wisely Canada is organized by a team of leading Canadian physicians, in partnership with the Canadian Medical Association. Choosing Wisely Canada is chaired by Dr. Wendy Levinson, Professor of Medicine at the University of Toronto and Officer of the Order of Canada.

It is now a truly national campaign in Canada and, in fact has spread to over 15 other countries including Australia, Brazil, England, Germany, Israel, Italy, Japan, Netherlands, New Zealand, Switzerland, Wales and elsewhere. Choosing Wisely Canada leads the international effort.

The Choosing Wisely International Learning Network has developed a starter kit with campaign principles and resources.

Choosing Wisely Canada recognizes the importance of educating and engaging patients so that they could make informed choices about their care. Choosing Wisely Canada has launched a patient facing campaign entitled, More Is Not Always Better, to help patients learn about the tests and treatments in question, when they are necessary and when they are not, and what patients can do to improve their health. Choosing Wisely Canada is working with various stakeholder groups to disseminate the patient materials widely.

Choosing Wisely Canada is also working with medical schools to introduce new content into the undergraduate, postgraduate and continuing medical education curricula. In an effort to engage medical students, Choosing Wisely Canada launched STARS (Students and Trainees Advocating for Resource Stewardship). STARS is designed to foster awareness amongst medical students in Canada about Choosing Wisely and specialty society lists of recommendations.

Opportunities are currently being identified, through partnerships with various health care organizations and associations, to support implementation of the physician recommendations in practice settings. Across Canada, there is currently a groundswell of local Choosing Wisely implementation projects – in hospitals, health regions, long-term care homes, primary care clinics, etc. – with many demonstrating dramatic reductions in the volume of unnecessary tests and treatments, we call these groups The Change Makers. Inspired by these efforts, Choosing Wisely Canada has launched a series of toolkits, which are simple to follow how-to guides to reducing overuse, waste and harm in different clinical settings. Each toolkit was developed by a clinician who has successfully implemented a Choosing Wisely recommendation in their setting, and achieved significant impact.

Thank you for your interest in Choosing Wisely Canada. For more information on the campaign, please contact us.

* The lists of “Five Things Clinicians and Patients Should Question” are not intended to be used to establish payment and coverage decisions. Rather, they are meant to spur conversation about what is appropriate and necessary treatment. As each patient situation is unique, clinicians and patients should use the Choosing Wisely Canada materials to determine an appropriate treatment plan together.