Doctors urged to ‘choose wisely’ and stop over-treatment

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The Academy of Medical Royal Colleges is bringing a North American initiative to get doctors to stop using interventions with no benefit to the UK.

A group of doctors from the academy, which comprises the 20 medical Royal Colleges and Faculties across the UK and Ireland, have written a piece in the BMJ about the Choosing Widely campaign which started in the USA and then Canada. It aims to stop doctors using various interventions “that are not supported by evidence, free from harm, and truly necessary, including those that duplicate tests or procedures already received”.

It works by asking medical organisations (such as medical royal colleges in the UK) to identify procedures commonly used in their specialty, “the necessity of which should be questioned and discussed”. These are compiled into lists and the top five interventions “should not be used routinely or at all”.

So far, more than 60 US specialist societies have joined in the Choosing Wisely initiative and it has also been adopted by other countries, including Australia, Germany, Italy, Japan, Netherlands and Switzerland. The AMRC doctors say this is “a clear sign that wasteful medical practices are a problem for all health systems”.

In the article they make four recommendations. First up, they say doctors should help patients accept “that doing nothing can often be the best approach” and secondly, the latter should be encouraged to ask questions.

Next, the authors say medical students should be taught about overuse of tests and interventions, as should practising doctors and finally they suggest commissioners should consider a different payment incentive for doctors and hospitals.

A steering group has been established to oversee the project chaired by Professor Dame Sue Bailey the Chair of the Academy. It includes representatives from patient groups, NHS England, NICE and the BMJ.