Medical students learning to Choose Wisely

From today, New Zealand’s medical students will benefit from Choosing Wisely[1].

The New Zealand Medical Students’ Association (NZMSA) is using recommendations from Choosing Wisely in training.

Choosing Wisely, which launched in December 2016, encourages New Zealand’s health professionals to talk to patients about unnecessary tests, treatments and procedures.

It centres on helping patients make good choices and focuses on areas where evidence shows that a test, treatment or procedure provides little or no benefit to a patient and could even cause harm. Examples are X-rays and CT scans, which can expose patients to cancer-causing radiation.

Council of Medical Colleges chair Dr Derek Sherwood says it is fantastic to know New Zealand’s medical students and trainee interns will have a good understanding of Choosing Wisely.

‘There are a large number of medical tests, treatments and procedures available, but that doesn’t always mean we should use them. Encouraging our medical students to discuss the risks and benefits of these tests with patients, so patients can make an informed choice, ensures the appropriate questions are asked from the very beginning of their careers.’

NZMSA representative Sam Grainger says the Association is grateful for the opportunity to develop recommendations specifically for medical students.

‘Involving students at this level helps us form good habits about resource stewardship, thereby protecting patients from harm and encouraging the appropriate use of health care resources.’

The NZMSA is using a list of eight prompts for medical students and trainee interns, including ensuring the test, treatment or procedure will make a difference to a patient’s care.

The NZMSA has also created an acronym for the Choosing Wisely key concepts:

• Why? What will this test, treatment or procedure change?

• Is there an alternative? Less invasive, less resource intensive?

• Seek clarification. Clarify why the doctor ordered this test

• Explore/explain. Be the patient’s advocate. Explore concerns, take time to explain why a test, treatment or procedure is/isn’t necessary.

‘The prompts are easy to remember – Choosing Wisely is about being WISE,’ says Dr Sherwood.

Four other agencies will also be using Choosing Wisely recommendations from today:

• Australian and New Zealand College of Anaesthetists

• Australian Society of Otolaryngology Head and Neck Surgery

• Society of Obstetric Medicine of Australia and New Zealand

• Australasian Paediatric Endocrine Group.

‘It has been less than a year since the Choosing Wisely website was launched in New Zealand, and we are very pleased with how many agencies have taken up the messages we are promoting. These five medical colleges and speciality societies join the 17 which had already taken up the challenge of Choosing Wisely,’ says Dr Sherwood.

[1] The Choosing Wisely campaign is being run by the Council of Medical Colleges, in partnership with the Health Quality & Safety Commission and Consumer New Zealand, and with support from many health sector groups. It has funding from the Commission and the Ministry of Health and sponsors including PHARMAC and Pacific Radiology.