Choosing Wisely

Helping physicians and patients engage in crucial conversations

Choosing Wisely LogoLaunched in 2012, an initiative of the American Board of Internal Medicine Foundation (ABIMF) called Choosing Wisely® focused on promoting these crucial conversations. The nation’s leading specialty societies, along with Consumer Reports, have joined Choosing Wisely to encourage physicians and patients to be aware of medical tests and procedures that may be unnecessary, and in some cases cause harm. Each participating specialty society created a list of “Things Physicians and Patients Should Question” that provide specific, evidence-based recommendations physicians and patients should use to make effective and safe decisions on the most appropriate care based on their specific situation. Locally, the Iowa Healthcare Collaborative (IHC) was awarded the 2013-2014 ABIMF grant to further advance the recommendations and concepts across Iowa.

Iowa 5

  1. Don’t obtain imaging studies in patients with non-specific low back pain; and don’t do imaging for low back pain within the first six weeks, unless red flags are present. *Due to very similar language, these two recommendations were combined into one.
  2. Don’t do imaging for uncomplicated headache. Imaging headache pains absent specific risk factors for structural disease is not likely to change management or improve outcomes.
  3. In the evaluation of simple syncope and a normal neurological examination, don’t obtain brain imaging studies (CT or MRI).
  4. Avoid unnecessary use of computed tomography (CT) scans in the immediate evaluation of minor head injuries.
  5. Don’t order sinus CT or indiscriminately prescribe antibiotics for uncomplicated acute rhinosinusitis.

Further information and resources for this initiative will be presented in various forums for Iowa physicians and communities. Additionally, visit the Iowa Healthcare Collaborative or the Choosing Wisely Foundation for more information.