gms | German Medical Science

Objective: Although doctors rely on standards and recommendations in medicine on all levels, variation in the use of diagnostic tools and treatments is a widespread phenomenon worldwide. To address this issue, the American campaign Choosing wisely was launched in 2012 seeking to advance a national dialogue on avoiding unnecessary medical tests, treatments and procedures. The campaign has since then spread to over twenty countries, including Germany, and the fall of 2018 the last country was Norway where the Norwegian Medical Association initiated the campaign challenging each professional society within the association to develop list of tests, treatments or services which that specialty commonly overuses.

Methods: Focusing on the dialogue between doctor and patient, the Choosing Wisely campaign seeks to establish a common understanding between doctor and patient of the actual benefit of different treatments and procedures. Both historical and psychological aspects affecting this dialogue are reviewed, as well as illustrative clinical examples and demographical procedural data from the Norwegian Health Atlas.

Results: To obtain a common understanding of treatment challenges between doctor and patient a set of standardized patient questions are recommended for every consultation. Also, professional societies are advised to identify key areas related to over-use in their field of medicine to help clinicians advocate austerity when talking to their patients.