I am the Patient Leader for Choosing Wisely Alberta, the made in Alberta version of a national physician movement called Choosing Wisely Canada; focused on reducing unnecessary tests, treatments, and procedures in the health system. The main purposes of the program are to improve quality care, patient satisfaction, and appropriate use of healthcare resources. At the heart of the program, physicians and patients and families are encouraged to engage in conversations about potentially unnecessary tests, treatments, and procedures; together making smart and effective decisions about care.

I came to this position through some unintentional, yet unmistakable means. Let me tell you a little more about myself, Choosing Wisely, and how this role has been my destiny (if you believe in that kind of thing).

I grew up on a dairy/grain/seed potato farm in Lacombe County; rooted in the history my grandparents established in 1936 when they immigrated from the Netherlands. Life then was harder than I can imagine, and thankfully I’ll never have to experience some of the same hardships inherent in settlement: readying farmland cut from the native bush to be able to produce crops that livelihoods depend on is beyond comprehension; the back breaking labour something few can now remember; the devastation of raising a large family, dependent on the garden for food to survive, only to have a July hail storm shred it into the soil.

When I think about some of my values, and why Choosing Wisely is a perfect fit for me, I can’t help but reflect on some of the ingrained values passed down to settle in me. Values such as frugality, stewardship, and accountability are imprinted on me, despite me not actually experiencing the hardships like my grandparents did in those years- Somehow the stories I was told filtered through me and became part of my fibre. My practices are no longer for survival, but I do believe they make a difference: I patch my kids clothes; I use leftovers and dream up ways to keep my family satiated; I save things because you just never know when they might come in handy; I tend and harvest a large garden; and love to re purpose items for everyday use. Why am I taking you back through all of these details? I believe that to go forward, you have to look back to understand where you came from.

My goal here is to help you understand the purpose of Choosing Wisely, and philosophically what is at the foundation of it.

Choosing Wisely Canada began in 2014, and interestingly was the Canadian version of a movement that originated in United States in an effort to curtail some of the unnecessary and excessive medicine that had been growing out of control. According to the Office of the Auditor General of Alberta, in their report called Better Healthcare for Albertans (May 2017), they state that ineffective or inappropriate use of available tools not only harms the patient-it wastes resources’ (p.15) and despite having some of the highest spending per person on healthcare in the world, we have great opportunity for improvement. In the recent report, the extraordinary cost linked to healthcare in Alberta is weighed, and Choosing Wisely is noted as a reliable quality improvement initiative aimed at responding to this issue.

When Choosing Wisely Alberta launched (also In 2014), they invited patients to be involved from the beginning (that’s where I came in). l joined as a patient advisor (representative); procured from the Health Quality Council of Alberta Patient Family Safety Advisory Panel; a volunteer position I have held for six years come October when I first agreed to add my patient voice to Choosing Wisely Alberta, I admit, I was unfamiliar with the initiative and knew little about what I was getting into (that’s the unintentional part).

For the first three years of Choosing Wise Alberta, headed by Alberta Medical Association, the priority was building partnerships with organizations such as Alberta Health, Alberta Health Services, Strategic Clinical Networks, Physician Learning Program, College of Physicians and Surgeons of Alberta, Alberta College of Family Physicians, Institute of Health Economics, Alberta innovates Health Solutions, Alberta Society of Radiologists, Health Quality Council of Alberta, University of Alberta, University of Calgary and Toward Optimized Practice. We introduced Choosing Wisely to a few patient groups (Did you know that there are over 100 patient and specialty health interest groups in Alberta?), and I am privileged to have a seat at the table on the steering committee and add my input from a patient perspective.

In addition to my role as patient advisor, I am also a 14-year career registered nurse; a hybrid position that has come under scrutiny in my years of experience. How can I be both? How can I impartially represent the patient perspective? You would be surprised to learn that there are a number of nurse/advocated advisor hybrids out there! I’ve encountered some questions about my ability to carry out the dual roles, and I explain by using a comparison: imagine you work in the restaurant industry and abide by the food safety standards and regulations, as well as principles of customer service. When you go out to dine at another restaurant, do you expect that the same level of care is taken so that you can eat food that is prepared safely and encounter respectful service? I liken my dual role to this comparison, and when I am a patient, or family member of a patient, I too am in a vulnerable position at the mercy of the health system. That is why I have dedicated a great deal of effort to my patient advisor roles; for the greater good. I no longer apologize for my unique fabric; I view it as an advantage that has contributed to my success.

This article first appeared in Lacombe County News. To download the PDF version of this article, please visit the Lacombe County News website.