Dr. Anthony Train, Calgary, and Dr. Kimberly Wintemute, Toronto, focused on four common clinical scenarios in family medicine that illustrated the tension family doctors face when they need to say no to patient requests for low-value care. Drs. Train and Wintemute suggested communication strategies and practical tools that encourage the kind of shared decision-making in which patients come to understand that some tests and treatments do not add value to their care, and may potentially cause unexpected and/or unforeseen harms. The topics highlighted in this presentation were based on the Choosing Wisely Canada family medicine list of ‘Things Patients and Physicians Should Question’ including: antibiotics, sedative hypnotics, imaging, and more.