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Family Medicine

by
College of Family Physicians of Canada
Last updated: September 2023

  • Recommendations 1-5
    The Canadian Medical Association’s (CMA) Forum on General and Family Practice Issues (GP Forum) is a collective of leaders of the General Practice sections of the provincial and territorial medical associations. To establish its Choosing Wisely Canada Top 5 recommendations, each GP Forum member consulted with their respective GP Section members to contribute candidate list items. Items from the American Academy of Family Physicians’ Choosing Wisely® list were among the candidates. All candidate list items were collated and a literature search was conducted to confirm evidence-based support for the items. GP Forum members discussed which of the thirteen items that resulted should be included. Agreement was found on eight of them. Family physician members of the CMA’s e-Panel voted to select five of the eight items. These five items were then approved by the provincial and territorial GP Sections. The College of Family Physicians of Canada is a member observer of the GP Forum and was involved in this list creation process. The first four items on this list are adapted with permission from the Five Things Physicians and Patients Should Question, © 2012 American Academy of Family Physicians.

    Recommendations 6 – 11
    Items 6 – 11 were selected from ten candidate items that were originally proposed for items 1 – 5. GP Forum members discussed which of these items should be included and agreement was found on eight of them. As was done for the first wave, family physician members of the CMA’s e-Panel voted to select five of the eight items; however, subsequent discussions by the GP Forum resulted in six items being chosen. Feedback on these six items was then obtained from the provincial/territorial GP Sections. The College of Family Physicians of Canada is a member observer of the GP Forum and was involved in this list creation process.

    The GP Forum was dissolved as of August 2015.

    Recommendations 12 and 13
    In late 2016, Choosing Wisely Canada partners – the College of Family Physicians of Canada and the Canadian Medical Association – formed the Pan-Canadian Collaborative on Education for Improved Opioid Prescribing, with the goal to reduce harm from opioids, decrease the variability in prescribing practices, and improve pain management for patients. The Collaborative formally reached out to Choosing Wisely Canada (CWC) in early 2017, requesting its involvement, citing the important role played by CWC in convening professional societies representing different clinical specialties to tackle unnecessary care. As a result, the ‘Opioid Wisely’ was launched in March of 2018 and items 12 and 13 were added to the preexisting family medicine list of 11 things patients and clinicians should question.

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Overuse of Tests and Treatments in Canada

Using Antibiotics Wisely in Primary Care

A campaign to help primary care clinicians use antibiotics wisely in practice.

Opioid Wisely

Encouraging thoughtful conversations about the harms associated with opioid prescribing.

Quality improvement is an important and integral competency for clinicians in Canada’s health care system. Choosing Wisely Canada has a suite of toolkits that can help kick-start your efforts to reduce overuse in primary care settings.

These toolkits can be applied for CPD in the following ways:

If you have questions or need help getting started, email info@choosingwiselycanada.org.

Bye Bye PPI

A toolkit for deprescribing proton pump inhibitors in EMR-enabled primary care settings.

Drowsy Without Feeling Lousy

A toolkit for de-prescribing benzodiazepines and other sedative hypnotics in primary care.

Understand the Gland

A toolkit for appropriate ordering practices of free thyroid hormone testing.

Bone Density Tests

When you need them and when you don’t.

ECG (Electrocardiogram)

When you need it and when you don’t.

Health Check-ups

When you need them and when you don’t.

Imaging Tests for Lower Back Pain

When you need them and when you don’t.

Pap Tests

When you need them and when you don’t.

Vitamin D Tests

When you need them and when you don't.