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.
So why do they occur? Well, there are many possible drivers of unnecessary tests, treatments, and procedures, including:
Choosing Wisely Canada is a national campaign to help clinicians and patients engage in conversations about unnecessary tests and treatments, and make smart and effective care choices.
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.
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 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 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 | 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 | Quebec 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 | Health Quality Ontario | Ontario College of Family Physicians | 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: ABIM Foundation | Bertelsmann Stiftung | Canadian Medical Association | Diagnostic Services Manitoba | Government of Alberta | Government of Canada | Government of New Brunswick | Government of Newfoundland and Labrador | Government of Northwest Territories | Government of Nova Scotia | Government of Nunavut | Government of Ontario | Government of Prince Edward Island | Government of Saskatchewan | Government of Yukon | Health Quality Ontario | Medical Society of Prince Edward Island | Medical Society of Prince Edward Island | Quebec Medical Association | Saskatchewan Medical Association | St. Michael’s Hospital | The Commonwealth Fund | University of Toronto
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 McDonald 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. Karen also manages the list development process, liaising with participating national medical specialty societies. Karen has been with the campaign since its founding and is a certified project management professional.
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.
Zach Bouck is Biostatistician for Choosing Wisely Canada. He is responsible for measuring the frequency and variation in the ordering of low-value care and identifying factors associated with overuse. Zach is also the staff biostatistician at the Institute for Health Systems Solutions and Virtual Care (WIHV) at Women’s College Hospital. Zach holds a Master in Public Health degree from the University of Saskatchewan.
Steph Callan is Project Coordinator for Choosing Wisely Canada. She is responsible for managing campaign communication channels, developing content and providing administrative support. Steph has a Bachelor of Arts in communications and multimedia from McMaster University and a postgraduate certificate in corporate communications from Sheridan College.
Françoise Ko is Regional Liaison for Choosing Wisely Canada. She is responsible for managing the relationships with provincial and territorial Choosing Wisely affiliates. She has extensive experience in health care including management consulting and overseeing large scale collaborative projects. Françoise holds a PhD in Pharmacology from the University of Toronto.
Hayley Thompson is Senior Project Coordinator for Choosing Wisely Canada. She is responsible for managing relationships with local implementers from across Canada and enabling the community to learn from one another, primarily through Choosing Wisely Talks. Hayley also provides communication and administrative support. Hayley has a Bachelor of Arts in communications from Wilfred Laurier University and a postgraduate certificate in business management from Mohawk College.
Dr. Sacha Bhatia is Evaluation Lead for Choosing Wisely Canada. Dr. Bhatia is a clinical cardiologist who is also the Director of the Institute for Health System Solutions and Virtual Care (WIHV) at Women’s College Hospital. He also serves as Assistant Professor in Department of Medicine at the University of Toronto and at the Institute for Health Policy Management and Evaluation. He has significant experience in health policy, and from January 2008 to December 2009 was the Premier of Ontario’s health and research and innovation policy advisor.
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. Lynn Wilson is one of the Primary Care Co-Leads of Choosing Wisely Canada. She is also a Professor in the Department of Family and Community Medicine and Vice Dean, Partnerships in the Faculty of Medicine at the University of Toronto. Dr. Wilson practices family medicine at the Women’s College Hospital Family Health Team in Toronto. Dr. Wilson has co-led a number of provincial and national projects regarding substance abuse education for physicians and is the co-editor of two textbooks on addiction medicine. Since 2011, Dr. Wilson has been the co-director of BRIDGES, a Ministry of Health funded project to support the design and implementation of innovative models of care that promote integration in the health care system.
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 Assistant Professor and the Director of Continuing Education and Quality Improvement in the Department of Medicine at the University of Toronto, Associate 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.