Physicians who choose rural practice are called upon to deliver care that they have limited experience with, most notably in emergency situations when they are the most skilled people around.
Although not everything on the Choosing Wisely lists is likely to reduce low-value care, it is a good starting point for a conversation about curtailing low-value interventions.
Comparative effectiveness research (CER) may become an important factor in Medicare coverage decisions, and the new health care law may make it more easily available to the public to help in medical decision making.
An evidence-based, patient-centered approach is the best way to convince colleagues accustomed to older practice methods of the value of instituting cost-effective screening practices.
Particularly in a small community, patients may want to avoid the social stigma of seeking mental health care by receiving it from their primary care physician—who may know them well enough to have some insights an unfamiliar specialist would not.