One of the medical industry’s favorite arguments for medical malpractice reforms that insulate negligent medical providers from liability for the harms they cause to medical malpractice victims who are not adequately compensated for their devastating injuries due to limits (caps) on damages that can recovered in medical malpractice cases is the cost to the U.S. health care system for so-called defensive medicine.
What Is Defensive Medicine?
Defensive medicine is commonly defined as the practice of ordering medical tests, procedures, or consultations of doubtful clinical value in order to protect the prescribing physician from medical malpractice claims.
One often-cited estimate of the cost of defensive medicine in the United States is that defensive medicine costs us $46 billion annually.
A recent study suggests that defensive medicine represents 2.9% of the spending on health care in the United States on a yearly basis (approximately $78 billion of the $2.7 trillion spent on U.S. health care annually), primarily as a result of additional hospital stays.
The Recent Study
Forty-two hospitalists in three hospitals were asked to complete a survey regarding their attitudes toward defensive medicine. The physicians were then shown their orders from the previous day and asked to rate them based on a 5-point scale (0 represented “not defensive” and 4 represented “completely defensive”). The researchers looked at the itemized costs of the orders, including the daily room costs and board costs associated with the orders. They then examined the relationship between the physicians’ costs due to defensive medicine and their expressed attitudes toward medical malpractice lawsuits.
The 39 physicians who agreed to participate (of the 42 physicians contacted) rated 4,215 orders for 769 patients. Four of the 39 physicians identified no defensive orders while 21 physicians rated at least one “mostly defensive” order — 28% of the orders and 13% of the costs were considered to be at least partially defensive but only 2.9% of the costs were completely defensive in nature. The researchers found that when compared to the physicians with the fewest defensive orders, those with 10% defensive orders or more generated similar costs per patient and placed a similar number of orders.
The researchers found that the physicians who wrote the most defensive orders spent less than those who wrote fewer defensive orders, indicating “the disconnect” between physician beliefs about defensive medicine and their contribution to costs.
While the recent study involved very few physicians in just three hospitals and looked at physicians’ “attitudes” as measured by their own ratings of the defensive medicine nature of their orders, and therefore the usefulness and conclusions of the study regarding defensive medicine in the United States are thus limited, it appears that physicians and the medical industry in general are over-playing their cards when they complain that defensive medicine is a major contributor to how they practice medicine and is a major contributor to health care costs in the United States.
Any additional medical malpractice tort reforms enacted to reduce the incidence of defensive medicine in the United States would have an unfair and catastrophic effect on the victims of medical malpractice and have a negative effect on the practice of safe medicine.
If you or a loved one were injured (or worse) due to medical negligence in the United States, you should promptly seek the legal advice of a local medical malpractice attorney in your state who may investigate your medical malpractice claim and represent you or your loved one in a medical malpractice case, if appropriate.
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