The SIGU Board of Directors (CD) during the Annual Congress 2017 has spread among members and members the survey, proposed by Choosing Wisely Italy, on the survey of satisfaction and appreciation of practices of inappropriateness, previously elaborated (February 2015). The aim was to assess whether within the society, the 5 recommendations that must be at the center of the medical patient dialogue are known and applied or if there are difficulties in their application. The results were very positive. At the same time, the campaign began to collect proposals for new recommendations on practices at risk of inappropriateness, both directly from the participants of the 2017 Congress and through the collaboration of the coordinators of the SIGU Working Groups and their members. The CD has thus collected further proposals from which the 5 recommendations listed here have been selected and developed. For their drafting, a review of the guidelines of the scientific societies, where available, and of the current literature has been carried out.