Corporations are arguably the most powerful social and economic institutions globally, with unprecedented power to shape public policy and consumption patterns. Medically related industries, including pharmaceutical, medical device and health technology corporations, seek to maximize shareholder value and demonstrate sustained growth over time, which necessitates the promotion of hyperconsumption. Clinicians and patients attempting to “choose wisely” are doing so within the context of multiple industry influences that are implicated in overuse. From the early days of medical education, to direct-to-consumer advertising, to sponsorship of clinical practice guidelines, Choosing Wisely advocates must contend with promotional efforts to expand markets and increase the volume of prescribing and purchasing. Curbing overuse will require systematic approaches that directly address and curtail the marketing, lobbying and public relations activities of medically related corporations.
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