Skip to main content

Main menu

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums

User menu

  • My alerts

Search

  • Advanced search
The College of Family Physicians of Canada
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums
  • My alerts
The College of Family Physicians of Canada

Advanced Search

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • RSS feeds
  • Follow cfp Template on Twitter
  • LinkedIn
  • Instagram
OtherPractice

Choosing Wisely Canada recommendations

Dr Guylène Thériault
Canadian Family Physician November 2018; 64 (11) 825;
Dr Guylène Thériault
Primary Care Co-Lead for Choosing Wisely Canada and Assistant Dean of Distributed Medical Education in the Department of Family Medicine at McGill University in Montreal, Que.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF
Loading
Figure

Family medicine recommendation 2

Do not use antibiotics for upper respiratory infections that are likely viral in origin, such as influenzalike illness, or self-limiting, such as sinus infections of less than 7 days’ duration.

What shared decision making strategies or tools have you implemented in your practice around this recommendation?

Shared decision making tools have a central place in my practice because they simplify my explanations and make patients aware of the potential implications of their choices. When it comes to upper respiratory tract infections (URTIs), I use visual and interactive aids more than formal shared decision making tools. Online resources can be helpful to fuel discussion and are accessible to patients on their own. I use a Centor score calculator collaboratively with patients who come in for a sore throat to help them understand how I came to my diagnosis and to make them a part of their care plan from the time they step into my office; I present them with the finding and my diagnosis, and we discuss what to do next. Another helpful prop I often use is a diagram showing how long bronchitis symptoms last. For viral infections, I use the follow-up sheet suggested by the Institut national d’excellence en santé et en services sociaux,* which explains to patients what they have and how to alleviate their symptoms. I think using these tools, along with the Choosing Wisely Canada poster Four Questions To Ask Your Health Care Provider† that I have put up in the office, helps to let patients know that I practise evidence-based medicine and that it is okay to ask me questions about their care plans.

What makes shared decision making around this topic challenging or rewarding?

It can sometimes be difficult to talk about treatment choices for URTIs because there is a widespread myth in our society that these infections need to be treated with antibiotics. We need to break down this popular belief so that we can engage patients in a dialogue about the treatments that are actually recommended for their condition. It is up to physicians not to assume that patients expect to be prescribed antibiotics.

I take the time to discuss my patients’ needs and work with them to come up with the best strategy to relieve their symptoms. More than anything, patients are looking for reassurance and the knowledge that we can quickly reevaluate their options if their condition does not improve.

Working this way is rewarding because it means that I can provide my patients with the information they need and clear their doubts so they can stick to their chosen treatment plan. Last winter, a 54-year-old patient came to see me for a case of acute bronchitis that would not go away despite the antibiotics prescribed by the first physician whom she had received treatment from. The patient and I talked about the different possible treatments, as well as the potential harms or consequences associated with them, and we agreed on a care plan that included drinking a certain amount of water every day, irrigating her nasal cavities with a saline solution, and using throat lozenges. When the patient left my office, she said that she felt extremely relieved that she did not have to take another course of antibiotics to cure her infection, and empowered to manage her own symptoms.

Why is shared decision making around this specific Choosing Wisely recommendation or clinical topic essential to you?

Shared decision making is essential to breaking the cycle of misinformation about URTIs. By arming patients with knowledge, encouraging them to start a dialogue with their physicians, and helping them identify their care preferences, we can improve the quality of medical practice at large.

Notes

Choosing Wisely Canada is a campaign to help clinicians and patients engage in conversations about unnecessary tests, treatments, and procedures, and to help physicians and patients make smart and effective choices to ensure high-quality care. To date there have been 13 family medicine recommendations, but many of the recommendations from other specialties are relevant to family medicine. In each installment of the Choosing Wisely Canada series in Canadian Family Physician, a family physician is interviewed about the tools and strategies he or she has used to implement one of the recommendations and to engage in shared decision making with patients. The interviews are prepared by Dr Kimberly Wintemute, Primary Care Co-Lead, and Hayley Thompson, Project Coordinator, for Choosing Wisely Canada.

Footnotes

  • ↵* The English and French versions of the Institut national d’excellence en santé et en services sociaux follow-up sheet are available at www.inesss.qc.ca/fileadmin/doc/INESSS/Outils/GUO/Anglo/InfectResp_Feuille-suivi-interactive_EN.pdf and www.inesss.qc.ca/fileadmin/doc/INESSS/Outils/GUO/InfectResp_Feuille-suivi-Interactive.pdf, respectively.

  • ↵† The English and French versions of the Choosing Wisely Canada poster Four Questions To Ask Your Health Care Provider are available at https://choosingwiselycanada.org/wp-content/uploads/2017/05/Four-questions-EN.pdf and https://choisiravecsoin.org/wp-content/uploads/2017/06/Four-questions-FR.pdf, respectively.

  • Copyright© the College of Family Physicians of Canada
PreviousNext
Back to top

In this issue

Canadian Family Physician: 64 (11)
Canadian Family Physician
Vol. 64, Issue 11
1 Nov 2018
  • Table of Contents
  • About the Cover
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on The College of Family Physicians of Canada.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Choosing Wisely Canada recommendations
(Your Name) has sent you a message from The College of Family Physicians of Canada
(Your Name) thought you would like to see the The College of Family Physicians of Canada web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Choosing Wisely Canada recommendations
Dr Guylène Thériault
Canadian Family Physician Nov 2018, 64 (11) 825;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Respond to this article
Share
Choosing Wisely Canada recommendations
Dr Guylène Thériault
Canadian Family Physician Nov 2018, 64 (11) 825;
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Family medicine recommendation 2
    • What shared decision making strategies or tools have you implemented in your practice around this recommendation?
    • What makes shared decision making around this topic challenging or rewarding?
    • Why is shared decision making around this specific Choosing Wisely recommendation or clinical topic essential to you?
    • Notes
    • Footnotes
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

Practice

  • Determining if and how older patients can safely stay at home with additional services
  • Managing type 2 diabetes in primary care during COVID-19
  • Effectiveness of dermoscopy in skin cancer diagnosis
Show more Practice

Choosing Wisely Canada

  • Reducing the use of proton pump inhibitors in infants with gastroesophageal reflux symptoms
  • How to decrease routine and repetitive blood tests in hospitalized patients
  • When urine testing to rule out infection does more harm than good
Show more Choosing Wisely Canada

Similar Articles

Navigate

  • Home
  • Current Issue
  • Archive
  • Collections - English
  • Collections - Française

For Authors

  • Authors and Reviewers
  • Submit a Manuscript
  • Permissions
  • Terms of Use

General Information

  • About CFP
  • About the CFPC
  • Advertisers
  • Careers & Locums
  • Editorial Advisory Board
  • Subscribers

Journal Services

  • Email Alerts
  • Twitter
  • LinkedIn
  • Instagram
  • RSS Feeds

Copyright © 2025 by The College of Family Physicians of Canada

Powered by HighWire