Choosing Wisely aims to identify low value services and advise physicians to avoid or at least be more conservative in the use of these services. The ability to implement these changes, however, depends on physician awareness of these initiatives. A paper by Colla and Mainor (2017) examines trends in awareness of the Choosing Wisely initiative:
Despite continued publicity and physician outreach efforts, there were no significant changes between 2014 and 2017 in awareness of the campaign among physicians (awareness increased from 21 percent to 25 percent) or physician-reported difficulty in talking to patients about avoiding a low-value service (42 percent reported that such conversations had gotten harder in 2014, and 46 percent did so in 2017). Barriers to the adoption of recommendations included malpractice concerns, patient demand and satisfaction, and physicians’ desire for more information to reduce uncertainty.