Experts estimate that 30% of care delivered in the United States is duplicative or unnecessary. To fight what equates to nearly $700 billion in wasted resources, the ABIM created the Choosing Wisely® initiative that encourages patients and physicians to have conversations about the overuse of tests. The Choosing Wisely campaign is supported by several medical societies and consumer groups. The initiative also has put out lists of the most overused and unnecessary tests in order to stimulate discussion amongst healthcare professionals. However some argue that simply having a discussion with patients may not be enough to curb unnecessary tests. Manoj Jain, an infectious-disease specialist in Memphis, TN, recently wrote an article for the Washington Post that explains there are several factors contributing to why physicians will write a prescription or order a test when it is not entirely necessary. Chief among doctors’ concerns is that they will miss a diagnosis and be sued for malpractice. This feeling is strongest among emergency medicine doctors who have to diagnose patients with whom they have no history. Also, doctors that own labs actually have a financial incentive to order more tests, and some will go so far as to order certain tests for all patients with specific symptoms. In order to truly reduce overuse or healthcare services, Jain suggests a system that tracks data on doctors’ prescribing and ordering patterns. That way they can compare the data to other doctors in the area and establish best practices. The other key is removing the financial incentive to order more services. Hopefully payment reform initiatives such as accountable care organizations, value-based purchasing, and bundled payments will do just that.