Choosing Wisely in general practice

Launched in Australia in 2015, Choosing Wisely is a global health initiative that is enabling clinicians, consumers and healthcare stakeholders to start important conversations about tests, treatments and procedures, where evidence shows they provide no benefit, or in some cases, lead to harm.

Choosing Wisely Australia invites peak health professional colleges, societies and associations to develop lists of tests, treatments and procedures that clinicians and consumers should question. To date, Choosing Wisely Australia is supported by 45 member colleges, societies and associations and has published more than 190 recommendations of healthcare to question. Members and supporters include the Royal Australian College of General Practitioners (RACGP), Australasian College of Rural and Remote Medicine (ACRRM) and the Australian College of Nurse Practitioners (ACNP).

Choosing Wisely Australia is also about empowering consumers to have the confidence to ask questions about their healthcare options, and for healthcare providers to create environments where consumers feel comfortable to do so.

There are a number of ways that general practices can get involved. These include through education, training and supporting conversations with consumers. We’ve compiled a list of resources for GPs, GP registrars, nurses and other staff that you can use to help raise awareness and implementation of Choosing Wisely in your everyday practice.

The RACGP has developed a list of 10 recommendations for GPs and other health professionals. These were developed by RACGP through consultation with their members to identify what tests, treatments or procedures should be questioned within their area of practice.

Choosing Wisely Australia also offers clinicians a suite of resources based on a range of tests, treatments, conditions and symptoms. The site provides links to resources produced by NPS MedicineWise and other reputable evidence-based healthcare organisations.

Choosing Wisely recommendations can be used to review and reflect on your own practice and the needs of your patients. You could also make Choosing Wisely a theme for self-directed learning activities such as:

• Evidence based medicine journal club
• Individual PDSA
• Small Group PDSA
• Small Group Learning.

A key objective of Choosing Wisely is to empower people to obtain the information and advice they need to make informed decisions about their healthcare, while at the same time encouraging health professionals to initiate conversations that explore options, necessity and risks.

To help guide consumers and carers in knowing questions they can ask their health professionals, Choosing Wisely Australia promotes a list of ‘5 Questions to ask your doctor’. These are available in various formats and have been translated into 12 different languages.

5 Questions to ask your doctor

5 Questions translated into 12 different languages

5 Questions wallet cards

5 Questions A4 poster

5 Questions A3 poster

The 5 Questions resources can be used by your practice in various ways. For example, providing your patients with the wallet cards to take to other consultations, and displaying the poster in the consultation room to encourage consumers to ask questions.

Want to know more about key Choosing Wisely recommendations? 

Choosing Wisely Australia principles, recommendations and resources have been integrated into a range of NPS MedicineWise online programs and resources.

• Opioids, chronic pain and the bigger picture
• Thyroid
• Low back pain (resources include “Low back pain: Do you need a scan?”)
• Neuropathic pain (includes video of physical examination for sensory tests)
• Abdominal imaging
• Knee and hip osteoarthritis
• Acute ankle & knee injuries

Our range of activities enable you to embed best practice and earn CPD.

Are you responsible for training future health professionals?

Many modules within the National Prescribing Curriculum (NPC) convey Choosing Wisely principles and recommendations. If your practice has registrars and medical students, they can undertake this series of interactive case-based modules designed to encourage confident and rational prescribing. These modules follow a stepwise approach as outlined in the WHO's Guide to Good Prescribing.

There are also three interactive modules available that present everyday clinical scenarios where analysis of medical test results might be encountered. The modules equip students with the knowledge and skills to determine the appropriate test and to effectively interpret the results.