CJEM Debate Series: #ChoosingWisely – The Choosing Wisely campaign will not impact physician behaviour and choices

[...]the basic premise of CW is to "promote conversations about unnecessary tests, treatments, and procedures, and to help physicians and patients make smart and effective choices to ensure high-quality care.Health care spending as a share of Gross Domestic Product in Canada has been decreasing since 2010.14Meanwhile, the Canadian Institute for Health Information (CIHI) reports that up to 30% of health care in Canada is potentially unnecessary.15Unnecessary imaging is estimated to cost Canadians $220 million annually and increases lifetime cancer incidence.16,17Despite this, 30% of patients presenting to Ontario and Alberta EDs for low-risk minor head trauma still received a CT scan.15As physicians, we are presiding over a rising sea of unnecessary tests and medications.Recognizing that starting with a fresh slate is significantly easier than unlearning bad habits, CW Canada launched Students and Trainees Advocating for Resource Stewardship (STARS) in 2015.36Delegates from all 17 Canadian medical schools learn about resource stewardship, how to think critically before ordering tests and treatment, and how to approach difficult conversations with supervisors and patients about unnecessary care.35They have organized events and interest groups to spread their knowledge of resource stewardship with other students, as well as influencing formal curricular changes.37Today's trainees will engage in conversations with patients before ordering a battery of tests or writing a mindless prescription because they know that shared decision-making and accurate risk/benefit assessments are the key behaviours of excellent doctors.