It has been a while since we have looked at the role of defensive medicine, or testing and procedures generated from fear of malpractice suits, in health spending. A Research Letter published in the Journal of the American Medical Association looked at the relationship between defensive medicine and the use of three hospital services. (JAMA Int. Med. Article) Thirty-nine hospitalists were involved in the study and were asked to rate their own level of defensiveness in regard to orders they actually placed in the treatment of patients. Defensiveness was rated on a scale from zero to four and the costs of the various orders was collected. An order not at all spurred by malpractice concerns was rated zero and various levels of defensiveness were represented from 1 to 4, with 4 being a completely defensive order. The relationship between use of defensive orders and a doctor’s attitude toward malpractice was also examined. Four physicians said they had no defensive orders and 21 had at least one order they said was largely defensive. Twenty-eight percent of all orders were defensive to some degree. Physicians with more defensive orders did not have significantly more total orders or significantly more overall cost per patient than did doctors with fewer defensive orders. About 13% of total patient costs were identified as due to defensive orders. Orders which were solely due to malpractice concerns were about 2.9% of costs, primarily via additional hospital days. While the authors refer to this as a small amount of cost, even the roughly 3% number would be billions of dollars in savings a year. Fear of malpractice is a real concern, both because of probably unnecessary utilization and cost it engenders, but also because it provides cover for physicians who may want to deliver more services for economic reasons.
✅ Subscribe via Email
About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
Healthy Skeptic Podcast
This is an outstanding report on total global drug spending and trends, with projections out to 2025. It helps you understand this important area of health care, which does much...
June 1, 2021
MedPAC 2019 Report to Congress
June 18, 2019
It may be investors that need the redesign. They just keep pouring money into this digital health crap despite all the losses. Redesign Health claims that it makes money by...
September 16, 2022
In truth, this seems like more money down a rathole. Google’s parent and other investors are putting a billion dollars into Google’s health arm, Verily. Apparently want to compete with...
September 12, 2022
It is like investors have learned nothing from the past two years. Even supposedly smart investors like Morgan Health, which is making a $20 million contribution to LetsGetChecked, which supposedly...
September 12, 2022
Access ACO Care Management Chronic Disease Comparative Effectiveness Consumer Directed Health Consumers Devices Disease Management Drugs EHRs Elder Care End-of-Life Care FDA Financings Genomics Government Health Care Costs Health Care Quality Health Care Reform Health Insurance Health Insurance Exchange HIT HomeCare Hospital Hospital Readmissions Legislation M&A Malpractice Meaningful Use Medicaid Medical Care Medicare Medicare Advantage Mobile Pay For Performance Pharmaceutical Physicians Providers Regulation Repealing Reform Telehealth Telemedicine Wellness and Prevention Workplace