Health Equity and Choosing Wisely

Publication Year: 2018
Patient Need Addressed: Patient satisfaction/engagement
Population Focus: Vulnerable/disadvantaged
Intervention Type: Best practices
Type of Literature: Grey


Insights Results

Overview of article

  • This brief introduces key findings from a full report that captures insights and recommendations from a day-long Call to Action Summit, “Leveraging Choosing Wisely as a Tool for Achieving Health Equity,” held in October 2017 that brought together more than 120 national and local Choosing Wisely experts, adopters and stakeholders as well as community partners to discuss how the campaign can be used to empower and engage underserved populations in seeking the most effective healthcare
  • Choosing Wisely is an initiative of the American Board of Internal Medicine Foundation (ABIM) to encourage patients and their healthcare providers to have better conversations about care choices and select care options that are supported by evidence, not duplicative of other tests or procedures already received, free from harm, and truly necessary


  • Overall, this report outlines 3 main categories that should be addressed to ensure Choosing Wisely is useful in achieving greater health equity in the United States: 1) Better support for care teams; 2) Increased consumer education; and 3) Using culturally relevant messages and channels to reach racially and ethnically diverse communities

Key takeaways/implications

  • The report also suggests several action opportunities and on which stakeholders could take a leadership role – national partners, health systems, community-based organizations, and regulators, payers or accrediting agencies. Among the recommendations are: 1) Align messaging about low-value care across medical specialties and care settings; 2) Engage community health workers (CHWs) to model questioning and information-seeking behavior for patients; and 3) Partner with trusted community leaders and neighborhood-based organizations to increase public awareness about overuse in healthcare
  • Summit participants, which included consumers, employers, health systems, payers and government representatives, identified several healthcare delivery system factors that create barriers for implementation such as limited time with clinicians, and insufficient clinician training on cultural competence and cultural humility. A key theme was that patient-clinician trust and respect was a particularly significant barrier for historically underserved populations