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Physicians and Defensive Medicine

By July 7, 2010Commentary

Lets be blunt about this.  Everyone knows that malpractice suits and fear of malpractice suits raises health care spending, both by increasing utilization of services that may not be needed by the patient and by raising insurance costs for providers.  But the trial lawyers lobby is powerful, especially, but not exclusively among Democrats, so nothing significant has been done about this issue, which would be a relatively easy way to quickly affect spending, compared to many other possible solutions.  A recent survey of physicians published in the Archives of Internal Medicine confirms the effect of litigation fear on physicians practice patterns.  (Archives Survey) (Extract Only)

The survey was conducted on 1231 physicians in primary care, surgery and other specialties.  The responses indicated that 91% of physicians believe that doctors order more tests and procedures than needed in order to protect themselves from being sued.  The responses were consistent across all physician types and characteristics and geographic areas.  While surveys can have methodological issues, the responses here are likely based on the respondents’ knowledge of their own or other physicians’ behavior in regard to this issue.    Increasingly sophisticated research suggests that defensive medicine is likely responsible for adding tens of billions of dollars a year to our health spending; spending which could be avoided by more restrictive rules in regard to malpractice suits–most importantly, making losing plaintiffs pay attorneys’ fees and costs and limiting the types and amounts of damages recoverable.

Another significant concern is that if we believe that evidence-based medicine will improve quality and lower costs, physicians will not practice in this manner without assurance that they won’t be sued.  No one is going to follow a guideline if they do so and may still be sued.   Politics in this country, and especially money in politics, overwhelms common sense and the facts on many issues and this is one of them.  The trial lawyers’ millions in contributions are costing the country tens of billions of dollars every year.

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