Eric Barbanel, M.D., a physician in Middletown, N.Y., spends as much time these days explaining to patients why they don't need medications as he does prescribing them.

"Sometimes they ask for an antibiotic before they even say hello," he says. But Barbanel has a message for them: More medicine is not always better medicine.  

To back that up, he points to several Consumer Reports brochures on the wall of the exam room: If you've just hurt your lower back, you probably don't need an MRI. If you're here for a routine physical, there's little point to an EKG. And antibiotics? They're useless against a cold.

"When I talk it through, they get it—95 percent of the time, we're able to come to a meaningful conclusion," Barbanel says.

Barbanel is determined to have his patients and their families understand that many types of care they're used to receiving—including care that he used to deliver himself—turns out to be needless. Many doctors still offer, and many patients expect, unproductive care that may be driven by habit, advertising, outdated training, or financial incentives, he says.

'Choosing Wisely' Has Its Fourth Anniversary

Barbanel credits his change in approach to a nationwide educational campaign, Choosing Wisely. The campaign, launched by the ABIM Foundation, turned four years old this month.

"I think my care has improved as a result, and my patients are happy," he says. 

Consumer Reports is a partner in the Choosing Wisely campaign, which is an effort to get patients and their providers to think twice, and talk together, about tests, drugs, and treatments that are not truly necessary.

The extent of unnecessary care? About 30 percent of U.S. healthcare expenditures, by several estimates. 

At the core of Choosing Wisely are more than 70 national medical specialty societies that have each named at least five common things they urge their colleagues to reconsider offering because the evidence just doesn't back them up.

450 Things to Question

From 45 recommendations when the campaign kicked off in April 2012, the list has grown to more than 450 items that providers and patients should question, including:

Also growing is the campaign's influence on care around the country and worldwide. Patients may find themselves in a conversation influenced by Choosing Wisely in Atlanta, San Francisco, Annapolis, or many other medical communities that have embraced the campaign.

The Robert Wood Johnson Foundation has supported more than two dozen local projects to bring Choosing Wisely values into practice. Similar campaigns now have been launched in a dozen countries.

Free Brochures, Posters, and Cards

Consumer Reports' contribution to the campaign includes more than 250 brochures, posters, rack cards and wallet cards, which are free for consumers and for like-minded organizations that wish to distribute them to their clients, members, employees, or the public.

Major employers, hospitals, government agencies and consumers now view those materials thousands of times a week online. Among the most popular are cautions about treatments for back pain, pink eye, and sinusitis.

No matter what medical issues you're facing, CR recommends that you and your family help promote these doctor-patient discussions. It can feel challenging at first, but make a practice of asking these five important questions, whenever a health care provider offers you something new:

  • Do I really need this test or procedure?
  • What are the risks and side effects?
  • Are there simpler, safer options?
  • What happens if I don't do anything?
  • How much does it cost?
To remember these questions, here is a card you can print and tuck next to your insurance card.