Choosing Wisely

...we want the best tests and best treatments for patients.

What is Choosing Wisely?

Choosing Wisely is a global initiative that seeks to encourage both doctors and patients to have a conversation about the value of treatments. The purpose of this initiative is to change doctors’ practice to align with best practice by getting them to stop using various tests, treatments and procedures that are:

  • not supported by evidence
  • not free from harm
  • truly unnecessary, including those that duplicate tests or procedures already received.

From the point of view of patients, they should be able to understand that some tests or treatments can be invasive and have undesirable side effects.

The Choosing Wisely initiative was born in USA and since then it has been spreading worldwide. In 2015 The Academy of Medical Royal Colleges also joined this movement, leading Choosing Wisely UK, which was officially launched in 2016, with forty treatments and procedures that were of little or no benefit to patients. Choosing Wisely UK is an ongoing initiative which aims to add new treatments and procedures to its list annually.

The College’s role in Choosing Wisely

The College’s role in Choosing Wisely is to identify tests, treatments or procedures commonly used in a pathology field that require a change in practice. We were invited to provide five recommendations in the first round of Choosing Wisely consultation. These recommendations have been adopted and are now published in Choosing Wisely UK.

A second round of Choosing Wisely consultation took place in February 2018 in which the College submitted four recommendations. These have now been published and added to the list of Choosing Wisely recommendations.

As an ongoing initiative, the College will be engaged in every Choosing Wisely consultation and therefore, we would like to offer the pathology community the opportunity to seek advice on initiating conversation with patients on any of the published topics. We also encourage College members to provide topics clinicaleffectiveness@rcpath.org for possible new recommendations to be taken into consideration for future Choosing Wisely consultations.

Topics for recommendation must be evidence-based and should cover a test, treatment or procedure which can be discussed with patients and are suitable for shared decision making. Any suggested recommendation must follow the following principles:

  • be in your specialty
  • be evidence based
  • be measurable and implementable.