Intended for healthcare professionals

Rapid response to:

Feature Shared Decision Making

Can doctors reduce harmful medical overuse worldwide?

BMJ 2014; 349 doi: (Published 03 July 2014) Cite this as: BMJ 2014;349:g4289

Rapid Response:

For some physicians Choosing Wisely initiative is a way to share with the colleagues and the consumers their longtime doubts about modern medical practice.
Five years ago I felt alone and marginally involved in medicine progress when I began to criticize overdiagnosis and overtreatment; in some occasions my colleagues silenced me because discussing about appropriateness was not popular and defensive medicine was the common way to answer to patients' attacks to our work.
But something was going to change. I was surprised to find my best partners in patients and their families, not the most educated ones. Simple, low educated patients appeared open to discussion and ready to understand the uncertanty of medicine and the limits of the use of technology .
At present we need time. Time to examine patients but expecially time to listen to them. They could help their physicians in this process of rethinking medicine and they can recognise our effort for a best quality in everyday practice of medicine. We could give them information, we can help to obtain a higher level of health education in our country, but we must rebuild confidence.
I met Slow Medicine in Italy and I am confident that the project "Fare di più non significa fare meglio" (Doing more does not mean doing better) is what we need to begin the change.

Competing interests: No competing interests

11 July 2014
Maria Congedo
neurologist in Italian National Health System
ASS 4 Mediofriuli Udine
via di Romagna, 40 34134 Trieste Italy