Choosing Wisely Canada launched on April 2, 2014, and is organized by a small team from the University of Toronto, Canadian Medical Association and St. Michael’s Hospital (Toronto).
It is part of a global movement that began in the United States in 2012, which now spans 20 countries across 5 continents.
Choosing Wisely Canada inspires and engages health care professionals to take leadership in reducing unnecessary tests, treatments and procedures, and enables them with simple tools and resources that make it easier to choose wisely.
It does so by partnering with professional societies representing different clinical specialties (e.g., cardiology, family medicine, nursing) to come up with lists of “Things Clinicians and Patients Should Question.” These lists of recommendations identify tests and treatments commonly used in each specialty that are not supported by evidence and could expose patients to harm.
Choosing Wisely Canada also partners with a wide range of medical associations, health system as well as patient organizations to help put these recommendations into practice.
Up to 30% of tests, treatments, and procedures in Canada are potentially unnecessary.
Unnecessary tests, treatments, and procedures do not add value for patients, potentially expose patients to harm, lead to more testing to investigate false positives, contribute to unwarranted stress for patients and their families, and consume precious time and resources. For example, Canadian and international guidelines say that seniors should not be on long-term prescriptions of benzodiazepines (sleeping pills). These powerful drugs can increase their risks for car accidents, falls and hip fractures. Yet, a 2017 study by the Canadian Institute for Health Information found that the rate of long-term benzodiazepine use among seniors ranged from 5% in Saskatchewan to 25% in New Brunswick.
So why do they occur? Well, there are many possible drivers of unnecessary tests, treatments, and procedures, including:
Professional Societies: Association of Medical Microbiology and Infectious Disease Canada | Canadian Academy of Child and Adolescent Psychiatry | Canadian Academy of Geriatric Psychiatry | Canadian Academy of Sport and Exercise Medicine | Canadian Anesthesiologists Society | Canadian Association for the Study of the Liver | Canadian Association of Advanced Practice Nurses | Canadian Association of Critical Care Nurses | Canadian Association of Emergency Physicians | Canadian Association of General Surgeons | Canadian Association of Hospital Dentists | Canadian Association of Medical Biochemists | Canadian Association of Medical Oncologists | Canadian Association of Medical Radiation Technologists | Canadian Association of Nuclear Medicine | Canadian Association of Paediatric Surgeons | Canadian Association of Pathologists | Canadian Association of Physical Medicine & Rehabilitation | Canadian Association of Radiation Oncology | Canadian Association of Radiologists | Canadian Blood and Marrow Transplant Group | Canadian Cardiovascular Society | Canadian College of Medical Geneticists | Canadian Critical Care Society | Canadian Dental Association | Canadian Dermatology Association | Canadian Fertility and Andrology Society | Canadian Geriatrics Society | Canadian Headache Society | Canadian Hematology Society | Canadian IBD Network of Researchers for Healthcare Growth and Improvement | Canadian Neurological Society | Canadian Nurses Association | Canadian Orthopaedic Association | Canadian Paediatric Society | Canadian Pediatric Neurosurgery Study Group | Canadian Pharmacists Association | Canadian Psychiatric Association | Canadian Rheumatology Association | Canadian Society for Surgical Oncology | Canadian Society for Transfusion Medicine | Canadian Society for Vascular Surgery | Canadian Society of Allergy and Clinical Immunology | Canadian Society of Clinical Chemists | Canadian Society of Hospital Medicine | Canadian Society of Hospital Pharmacists | Canadian Society of Internal Medicine | Canadian Society for Medical Laboratory Science | Canadian Society of Nephrology | Canadian Society of Otolaryngology: Head and Neck Surgery | Canadian Society of Palliative Care Physicians | Canadian Society of Respiratory Therapists | Canadian Society of Endocrinology and Metabolism | Canadian Spine Society | Canadian Urological Association | Canadian Association of Gastroenterology | Long Term Care Medical Directors Association of Canada | Occupational Medicine Specialists of Canada | Public Health Physicians of Canada | Society of Obstetricians and Gynaecologists of Canada | Society of Rural Physicians of Canada | Trauma Association of Canada
Medical Associations: Alberta Medical Association | Canadian Medical Association | Doctors Manitoba | Doctors Nova Scotia | New Brunswick Medical Society | Newfoundland and Labrador Medical Association | Northwest Territories Medical Association | Ontario Medical Association | Saskatchewan Medical Association | Yukon Medical Association
Health System Organizations: Canada Safe Imaging | Canadian Agency for Drugs & Technologies in Health | Canadian Association of Professors of Medicine | Canadian Deprescribing Network | Canadian Federation of Medical Students | Canadian Foundation for Healthcare Improvement | Canadian Institute for Health Information | Canadian Partnership Against Cancer | Canadian Patient Safety Institute | Canadian Task Force on Preventive Health Care | College of Family Physicians of Canada | Fédération des médecins résidents du Québec | Fédération médicale étudiante du Québec | Healthcare Insurance Reciprocal of Canada | Health Quality Ontario | Ontario Medical Students Association | Resident Doctors of Canada | Royal College of Physicians and Surgeons of Canada | Touchstone Institute
Patient Organizations: Canadian Arthritis Patient Alliance | Canadian Association of Retired Teachers | Canadian Association of Social Workers | Consumer Reports Health | Crohn’s and Colitis Canada | Gastrointestinal Society | National Association of Federal Retirees | Patients Canada | Patients for Patient Safety Canada | Retired Teachers of Ontario
Financial Supporters: Choosing Wisely Canada is supported by the University of Toronto, St. Michael’s Hospital (Toronto) and the Canadian Medical Association. It receives funding from the Canadian Medical Association, along with grants from federal, provincial and territorial ministries of health, and other partner organizations and agencies.
Choosing Wisely Canada does not accept financial support from pharmaceutical, medical devices or any other life sciences companies.
Choosing Wisely Canada is an open campaign, meaning that anyone can participate, and there are many ways to do so. You can:
The Choosing Wisely Canada brand may only be used for the purpose of participating in the campaign and furthering its mission. If you are using or planning to use the Choosing Wisely Canada brand in your work, please read the Brand Book to understand the conditions under which the brand may and may not be used, and to access our brand assets.Download the Brand Book
Dr. Wendy Levinson is Chair of Choosing Wisely Canada. She is also Professor of Medicine at the University of Toronto. Dr. Levinson is a national and international expert in the field of physician-patient communication and, in particular, on the disclosure of medical errors to patients. Dr. Levinson has led efforts to educate and engage medical students, residents and faculty members in patient safety, quality improvement, and the stewardship of finite resources. She was a member of the ABIM Foundation Board of Trustees when they created the Choosing Wisely campaign in the United States.
Tai Huynh is Campaign Director of Choosing Wisely Canada. He is responsible for campaign strategy and creative direction, and leads Choosing Wisely Canada’s implementation program. Tai brings to the campaign many years of experience in leading large-scale health system initiatives. He was previously Director of the Excellent Care for All Strategy at the Ontario Ministry of Health and Long-Term Care, and is also Creative Director at OpenLab at the University Health Network in Toronto.
Karen Born is Knowledge Translation Lead for Choosing Wisely Canada. She is responsible for the dissemination of campaign content to patients and the public and the integration of Choosing Wisely Canada into medical education. Karen also helps organize the Choosing Wisely international collaboration. Karen co-founded the health care policy blog, www.healthydebate.ca, and is an Assistant Professor in the Institute of Health Policy, Management and Evaluation at the University of Toronto.
Steph Callan is the Communications Specialist for Choosing Wisely Canada. She is responsible for campaign communications, including managing a variety of communication channels and developing content. Steph has a Bachelor of Arts in communications and multimedia from McMaster University and a postgraduate certificate in corporate communications from Sheridan College.
Doreen Day is the Project Manager, Pan-Canadian Initiatives for Choosing Wisely Canada. She is responsible for managing the relationships with provincial and territorial Choosing Wisely affiliates as well as managing the development and implementation of the campaign’s pan-Canadian initiatives. Doreen holds a Master’s degree in Health Administration from the University of Toronto.
Tara Goodale is Manager of Operations for Choosing Wisely Canada. She is responsible for all day to day operations of the campaign, including staff and stakeholder management, strategic planning, budgeting and financial reporting. Tara holds a Master’s degree in Family Relations and Human Development from the University of Guelph.
Gillian Hurwitz is the Project Manager, Implementation for Choosing Wisely Canada. Gillian is responsible for advancing the campaign’s implementation efforts, including overseeing a national initiative to reduce unnecessary antibiotic use across Canada. Gillian holds a Masters degree in Public Health from Boston University.
Saranega (Jaana) Ranchithan is a Project Coordinator with Choosing Wisely Canada. She is responsible for providing administrative and coordination support for communication and implementation efforts related to the campaign. She also provides support to the development of various on-going special projects. Jaana has a Bachelor of Science from the University of Toronto and is currently enrolled in the Health Services Management program at the Chang School for Continuing Education at Ryerson University.
Joanna Wong is a Project Coordinator with Choosing Wisely Canada. Joanna is responsible for providing core administrative support for multiple campaign activities. This includes working with specialty societies to develop and maintain their lists of recommendations and coordinating with the campaign’s regional and territorial affiliates. She is also responsible for supporting the international Choosing Wisely collaboration. Joanna has a Bachelor of Arts in psychology and linguistics from the University of Toronto.
Dr. Jeremy Grimshaw is the Implementation Science Lead for Choosing Wisely Canada. Dr. Grimshaw is trained as a family physician prior to undertaking a PhD in health services research at the University of Aberdeen. His research focuses on the evaluation of interventions to disseminate and implement evidence-based practice. Dr. Grimshaw is a Senior Scientist, Clinical Epidemiology Program, Ottawa Hospital Research Institute, a Full Professor in the Department of Medicine, University of Ottawa and a Tier 1 Canada Research Chair in Health Knowledge Transfer and Uptake. He is a Fellow of the Canadian Academy of Health Sciences and a Corresponding Fellow of the Royal College of Edinburgh. He is the President of the Board of the Campbell Collaboration.
Dr. Chris Hillis is Medical Education Specialist for Choosing Wisely Canada. Dr. Hillis is a hematologist and an Assistant Professor in the Department of Oncology at McMaster University and the Institute for Health Policy, Management and Evaluation at the University of Toronto. He completed his clinical training at McMaster and a Masters in Quality Improvement at University of Toronto. He was also a Quality Scholar with the US Veterans Affairs. His clinical work focuses on the care of patients with myeloproliferative neoplasms and myelodysplastic syndrome.
Dr. Jerome Leis is the Physician Lead for the Using Antibiotics Wisely campaign. Dr. Leis is also an Infectious Diseases physician at Sunnybrook Health Sciences Centre and Associate Professor in the Department of Medicine and the Centre for Quality Improvement and Patient Safety at the University of Toronto. His research is focused on the development of new models of care to reduce the risk of hospital-acquired infection and to promote the appropriate use of antibiotics.
Dr. Yulia Lin is the Physician Lead for the Choosing Wisely Canada Transfusion campaign. Dr. Lin is also an Associate Professor in the Department of Laboratory Medicine and Pathobiology at the University of Toronto and Division Head of Transfusion Medicine and Tissue Bank at Sunnybrook Health Sciences Centre. She is Chair of the Ontario Transfusion Quality Improvement Plan Committee, the Ontario Transfusion Coordinators Network Steering Committee and the Planning Committee for the University of Toronto Transfusion Camp, a postgraduate transfusion education program with participation from over 12 Canadian universities. Her scholarly interests include physician education in transfusion medicine, quality improvement in patient blood management and transfusion safety.
Dr. Christine Soong is the Clinician Lead, Hospital Designation Program for Choosing Wisely Canada. Dr. Soong is the Hospital Medicine Division Head at Sinai Health and the Department of Family and Community Medicine in Toronto. She is also the Medical Director for Quality and Safety at Sinai Health. Dr. Soong has led numerous quality improvement initiatives focused on improving care transitions and hospital discharge, resource stewardship, and reducing the inappropriate use of psychotropic medications in hospitalized patients.
Dr. Guylène Thériault is a Primary Care Co-Lead for Choosing Wisely Canada. She is a Family Physician and practices family medicine in Gatineau, Québec. She also practices in public health and has academic responsibilities at McGill University. She teaches many different types of audiences on the use of evidence in practice including students, residents, physicians and the public, and has an interest in prevention, screening and appropriate use of resources.
Dr. Kimberly Wintemute is one of the Primary Care Co-Leads for Choosing Wisely Canada. She is also a Family Physician and was Medical Director of North York Family Health Team from 2008-2016. She practices family medicine in its entirety, including obstetrics and palliative care. Kimberly works closely with allied health professionals to promote practice to full scope for all providers through the use of medical directives and standardized clinical pathways. She promotes quality improvement activities throughout her team, relying regularly on electronic primary care data as a guide for decision making. Choosing Wisely Canada resonates with the work done by her Family Health Team, and with her own principles as a family doctor.
Dr. Brian Wong is Medical Education Lead of Choosing Wisely Canada. He is also an Associate Professor and the Director of Continuing Education and Quality Improvement in the Department of Medicine at the University of Toronto, Director for the Centre for Quality Improvement and Patient Safety at the University of Toronto, and a Clinician Educator with the Royal College of Physicians and Surgeons of Canada. Clinically, he is a staff general internist at Sunnybrook Health Sciences Centre. His scholarly activities lie at the intersection between medical education, quality improvement and patient safety, and has been extensively involved in developing curricula to teach patient safety, quality and value to health professionals across the learning continuum.
Cindy Dumba is a lead Patient Partner with Choosing Wisely Saskatchewan. Cindy’s passion to empower patients and their families began with her interactions with the health care system as the primary companion, caregiver and advocate for both her parents. She has worked in Long-Term Care as a Continuing Care Aide and has always had a deep interest in health care quality improvement. Cindy has been active in the local, provincial, and national levels as a Patient and Family Advisor, focused on providing patients and families a voice and an active role in their own health care through education and communication. She is also a member of the Choosing Wisely Canada Implementation Research Network (IRN) team as well as the IRN Executive Group.
Amy Ma is a Public Representative for Choosing Wisely Canada. She is a member of the Montreal Children’s Hospital’s Family Advisory Forum since 2012, and has also been serving as co-chair of the McGill University Health Centre’s (MUHC) Central Patients’ Committee since 2014. Her experience in accompanying one of her children through a health issue motivates her to harness patient and family voices as a force for positive change in the healthcare system. Ms. Ma is a past board member of Yee Hong Centre for Geriatric Care and volunteered with the 1997 Special Olympics World Winter Games. She has a particular interest in issues involving health equity in a multicultural context, maternal health, the elderly and accessibility.