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Highly Accessed Editorial

The Choosing Wisely initiative: Does it have your back?

David S Pisetsky

Author Affiliations

Duke University Medical Center, 151G, Durham VA Medical Center, Durham, NC 27705, USA

Arthritis Research & Therapy 2013, 15:117  doi:10.1186/ar4257

Published: 22 August 2013

First paragraph (this article has no abstract)

As a subspecialty, rheumatology demands knowledge, intuition, and judgment to go along with a broad appreciation of the nuances and mysteries of internal medicine. Creativity is also part of the practice since many conditions in the purview of rheumatology lack established therapies that have received US Food and Drug Administration approval or testing in a controlled trial. Therefore, rheumatologists must create treatment plans, often on the fly (or by the seat of their pants), producing a succession of n-of-1 trials in their practices. As if their current attributes were not enough, rheumatologists, like other providers, must now have wisdom and practice not only smartly but wisely. Such is the direction of Choosing Wisely.