The Choosing Wisely campaign sought to prompt physician-patient conversations about unnecessary care. At its 2012 launch, physicians and patients felt uncomfortable about “denying” even unnecessary or potentially harmful care. Opponents of the Affordable Care Act raised fears of rationing and death panels. Physicians and patients had long mistrusted the motives of third parties, including employers, health plans and government. Physicians feared policies designed to reduce cost would impair their autonomy and patient care.