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Screening

Choosing Wisely Canada

A quick list of high-impact recommendations from Choosing Wisely Canada that are relevant to family medicine.

Last reviewed 2026-01-04|Canada-specific guidance

Family medicine: tests and treatments to question

  • Do not do imaging for low back pain unless red flags are present or serious underlying disease is suspected.
  • Do not prescribe antibiotics for otitis media in children aged 2-12 with non-severe symptoms when observation is reasonable.
  • Do not prescribe antibiotics for uncomplicated sinusitis unless symptoms are severe, prolonged, or worsening.
  • Do not do annual pelvic examinations or Pap tests on asymptomatic, non-pregnant women who are not at increased risk.
  • Do not routinely prescribe antibiotics for pharyngitis unless Group A Streptococcus is confirmed.
  • Do not routinely use neuroimaging for headaches unless red flags are present.
  • Do not order blood work at annual check-up in asymptomatic adults.
  • Do not do bone density testing in women younger than 65 or men younger than 70 without risk factors.
  • Do not order CBC and chemistry testing for minor trauma.
  • Do not routinely screen for prostate cancer using PSA or DRE.
  • Do not screen for colorectal cancer in asymptomatic patients with a life expectancy of less than 10 years.
  • Do not order thyroid function tests in asymptomatic patients.
  • Do not order ECG as part of a routine exam in asymptomatic, low-risk patients.
  • Do not order chest X-ray as part of a routine exam in asymptomatic, low-risk patients.

References