choosing wisely canada

Choosing Wisely Canada is the national voice for reducing unnecessary tests and treatments in health care. 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.

Unnecessary care in Canada

Canadians have more than 1 million potentially unnecessary medical tests and treatments every year. Unnecessary tests and procedures do not add value to care and can potentially harm our patients, while contributing to longer wait times and wasting health system resources. To learn more, read the Canadian Institute for Health Information (CIHI) report on unnecessary care in Canada.

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:

  • Practice habits are traditionally difficult to change, even in the face of new evidence

  • Patients might request tests and treatments without having all the information about risks and benefits

  • Lack of time for shared decision-making between clinicians and patients

  • Outdated decision-support systems encourage over-ordering

  • Defensive medicine and fear of malpractice lawsuits drive over-investigations

  • Payment systems reward doing more