Health committee  The OECD quality effort that Canada is very involved in could be a source of information too. As I said, they do comparisons across the countries. They have consistent information, yearly, in their “Health at a Glance” report—Canada is part of that—looking at rates of antibiotic

Health committee  I think there are some communication skills that are really fundamental, too, because often physicians are trying to please the patient, but they don't ask the question, “What are you most fearful of? What are you most worried about? What do you think this antibiotic will do for

Health committee  It's interesting. I'll handle that, because I've done some research personally on the relationship of communication to medical malpractice. I studied the attitudes of U.S. physicians versus those of Canadian physicians, and Canadian physicians grossly overestimate their risk of b

Health committee  There are a lot of studies looking at how to change physician behaviour. Earlier I mentioned audit and feedback, to tell you how you perform compared to your neighbour. Another one is asking physicians to check off why they're prescribing that particular drug and what the indicat

Health committee  I'll just add to that. There is a variety of things that we do know work that are pretty simple to do, like audit and feedback. If you show me that I'm prescribing twice as much as my colleague for similar patients, I'll think, “Wow, I'd better change that.” There are some very

Health committee  If I can add one quick thing, I thought a really important part of the Naylor report was about fostering innovation in general, because I think we have a pretty stagnant health care system and we don't innovate very easily in our health care delivery. I think that would infuse

Health committee  I would just add another point, though. All of this is true. There are also certain research issues where we might want to have our experts around the country. For example, we might want social scientists to help us figure out, based on behavioural economics and social science, t

Health committee  First of all, I think most people are more worried about their own infection, and this might seem theoretical to them, bugs that are resistant somewhere in the hospital. The research shows that you have to actually have people understand the risks to themselves. If people underst

Health committee  There are a lot of guidelines in many specialties. You've seen how doctors and societies produce guidelines, but they often address what we should do and not what we shouldn't do. They very rarely tell you what to stop. Think of all the older patients you know who are on a zillio

Health committee  I think probably some of the other people know the World Health Organization work better than I do.

Health committee  If we just step back in the broader context, there are many reasons why doctors over-order both prescriptions and tests. Sometimes patients want them, and that is particularly true on the antibiotic side in the outpatient sector. Sometimes it's just that it takes longer to expl

Health committee  There's no magic bullet. As you're hearing, this is a complicated problem. There are some things that need to be done at a policy level and through surveillance and all the things you're hearing about. What we think also is that you have to engage health care professionals in t

Health committee  Thank you for the privilege of addressing your committee. I am here in my role as the chair of Choosing Wisely Canada. We are a national clinician-led campaign that helps clinicians and patients have conversations about unnecessary tests, treatments, and procedures in order to