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Going Beyond the List: Canadian Society of Internal Medicine

The Canadian Society of Internal Medicine (CSIM) has been a leader in embedding Choosing Wisely principles into practice. CSIM was part of the first wave of medical professional societies to release a list of recommendations with the launch of Choosing Wisely Canada in April 2014. Since that time, the Society has gone beyond the list to find innovative ways of engaging their members in the campaign. From quality improvement initiatives to engaging the next generation of internal medicine professionals, CSIM continues to lead efforts to reduce overuse in the health care system.

CSIM represents clinicians, educators, researchers, and trainees in internal medicine who provide expert care to complex patients in community and academic hospital settings.  Many professionals working in internal medicine routinely see patients with multiple health conditions and comorbidities.

Dr. Adina Weinerman, who is an internal medicine physician at Sunnybrook Health Sciences Centre in Toronto, and leads Choosing Wisely efforts with CSIM, sees firsthand the problem of unnecessary tests and treatments in treating complex patients in internal medicine.

“Although many of these are of course necessary, we also see the high percentage of these tests that are unnecessary,” says Dr. Weinerman, “We see the harm that these tests can have on patients, but also the downstream effect to the system, where tests and treatments that patients actually need become less timely and efficient.”

To ensure their members are aware of the importance of the campaign, CSIM has embedded Choosing Wisely into their annual meeting in plenary, workshop and poster and abstract presentations. The annual meeting is a valuable opportunity to communicate Choosing Wisely to members, bringing together health professionals from across Canada to learn and engage with one another.

The society has also ensured the annual meeting showcases their ongoing engagement in the campaign.  For example, in March 2018, CSIM was one of the 12 participating societies to release a new recommendation related to safe opioid prescribing. At the 2018 Annual Meeting, CSIM is planning to host a workshop where participants will work in small groups to create a proposal to implement a Choosing Wisely initiative based on this recommendation and will share feedback with other groups.

“The annual meeting is an efficient way to communicate updates with our members, start conversations around this important topic, and get members engaged in quality improvement and research projects in this area,” says Dr. Weinerman.  “It is an organic way to help spread and promote important initiatives across the country.”

This has been an exciting year for CSIM and their continued engagement with the campaign. In addition to their Opioid Wisely recommendation release in March and embedding Choosing Wisely in the annual meeting, CSIM also plans to release five new evidence-based recommendations in the fall.

As a partner since the beginning of the Choosing Wisely Canada campaign, CSIM has demonstrated how going beyond the list can ensure members stay engaged and informed on best practices in internal medicine.  It is inspiring to campaign partners, colleagues and patients to see the leadership of CSIM in Choosing Wisely and their continued commitment to put campaign recommendations into practice.

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