It’s natural as one year winds down to start thinking about the year ahead, focusing on self-improvement. Maintaining or improving one’s health frequently tops the list of annual resolutions.

But even the healthiest folks fall ill now and then, not to mention the broad swath of folks who missed the healthy-living bandwagon in the first place. A new nationwide campaign that promotes a common-sense approach to seeking and dispensing medical care — while reducing unnecessary tests, medications and procedures — provides valuable guidance for patients and physicians alike. The program should be widely adopted in Hawaii and throughout the United States.

The Choosing Wisely campaign was conceived and piloted by the National Physicians Alliance, which, through a grant from the American Board of Internal Medicine Foundation, aims to promote conversations between health care providers and patients that help patients receive care that is:

» supported by evidence;

» not duplicative of other tests or procedures already received;

» free from harm; and

» truly necessary.

We’d go so far as to hail this as a practically old-fashioned attitude toward medical treatment, harking back to the days when doctors were more likely to take a "wait and see" approach and patients were more willing to leave the physician’s office without a fistful of prescriptions for antibiotics. These days, the use of electronic medical records is a key element of the Choosing Wisely initiative, a modern update that ensures doctors are fully aware of a patient’s previous treatments and overall health history and brings the system thoroughly into the 21st century.

Choosing Wisely relies on a combination of expert medical training and experience, common-sense communication between doctors and patients, and cutting-edge technology to offer optimal health care during an era rife with wasteful spending. The U.S. Congressional Budget Office, for example, has estimated that up to 30 percent of health care spending in the United States is unnecessary.

It will take heightened awareness on the part of physicians to stop reflexively ordering tests or treatments that may not help patients, and for patients and their guardians to stop demanding levels of treatment that are not warranted according to medical science. Less can be better, for the health of individual patients and for the health care system overall.

In practical terms, this meansthat a patient who goes to the emergency room with a headache may not automatically receive a CT scan; or a pediatrician might advise the parents of a child with pink eye that antibiotics don’t cure the viral form of the disease, and cool compresses are a better treatment; or that a low-risk patient going in for surgery can skip the typical pre-operative chest X-ray, known to be a risk, rather than an aid, for many patients.

These are just a few of the examples included in the Choosing Wisely initiative, through which more than 60 medical speciality societies have come up with lists of outdated, unsupported tests and treatments that doctors and patients should question. More detailed information can be found at http://www.choosingwisely.org/.

Although cutting health-care costs may be a welcome side effect of the Choosing Wisely approach, the greatest benefit will be in reducing the overtesting and overtreatment of patients, individuals who always need a healing touch but not necessarily a massive medical intervention.