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Feature Too Much Medicine

Choosing Wisely: setbacks and progress

BMJ 2015; 351 doi: (Published 15 December 2015) Cite this as: BMJ 2015;351:h6760
  1. Jeanne Lenzer, associate editor, The BMJ, New York, USA
  1. jeanne.lenzer{at}

Despite questions about its effectiveness the campaign is beginning to change attitudes, Jeanne Lenzer reports

The Choosing Wisely campaign has suffered some setbacks lately. First came the withdrawal of a medical professional society from the campaign, and then came an analysis showing that doctors haven’t changed their practices since the launch of the campaign.

To make matters worse, there are disagreements among the societies, with some charging that others are interfering with their turf and that self interest and money have made some recommendations less than useful.

But others see signs of progress and a thriving project still in its infancy.

The Choosing Wisely campaign grew out of a project by the National Physicians Alliance to reduce low value or potentially harmful interventions and was funded by the American Board of Internal Medicine Foundation. Now 70 professional societies list 400 “top five” recommendations to reduce low value interventions.


In June 2015, the American Association of Clinical Endocrinologists, based in Jacksonville, Florida, informed its members that it was withdrawing from the Choosing Wisely campaign. The association, jointly with the Endocrine Society, had issued its top five list in 2013, including a recommendation against ordering total or free T3 tests when monitoring levothyroxine (T4) therapy.1 The association gave its membership varying reasons for its withdrawal from the campaign.

Daniel Einhorn, association president in 2013-14, told The BMJ that the association withdrew from the campaign because it disagreed with the Endocrinology Society over the recommendation regarding T3 monitoring. Einhorn said the association decided not to lend its name to projects “we don’t fully control.”

The Choosing Wisely project is also facing scrutiny about …

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