Defensive Medicine Driving Up Health Care Costs, Says Study

Research shows that 75% of all doctors face a medical malpractice lawsuit at some point during their careers. For high-risk areas such as obstetrics and gynecology, the figure approaches 100%. A new study suggests that the specter of medical liability claims and medical malpractice lawsuits has a profound effect on the way doctors practice medicine. In so-called “defensive medicine,” doctors either order unnecessary tests or perform unnecessary procedures out of a fear of medical malpractice claims:

• 91% of doctors reported seeing a colleague order more tests than were medically needed
• 74% of doctors referred a patient to a specialist when there was no compelling reason to do so
• 84% of hospital administrators opined that there was a direct link between unnecessary procedures and fear of a medical liability claim

Defensive medicine driving up health care costs

In strictly statistical terms, defensive medicine accounts for approximately two percent of medical spending in the United States. While certainly placing the problem in context, statistics alone may not tell the whole story. In addition to the direct costs of extra tests and extra specialists, there are indirect costs.

Research shows that the average doctor spends over 10% of his or her time litigating medical malpractice lawsuits. As a result, many are more concerned with making a mistake than they are with their patients’ well-being. These concerns are much more pronounced among physicians who have recently been defendants in medical liability cases, and particularly those doctors who have been found liable for damages. Another indirect impact may be the doctor’s overall attitude. A doctor who is fearful is less aggressive, and may be less likely to embrace newer medicines and procedures.

Causes of defensive medicine

Many industry analysts are quick to blame the increasing number of medical malpractice claims for doctors’ timidity. They assert that there is a one-to-one relationship between malpractice lawsuits and defensive medicine: if you reduce lawsuits or the threat of litigation, then you reduce defensive medicine. This argument claims that an insecure doctor is an ineffective doctor, and that the fear of mistakes leading to litigation may be at the heart of defensive medicine issues.

Possible solutions

Some advocates have called for “safe harbors” in medical procedures, which would give doctors immunity from liability if they followed established protocols. Others promote programs such as Choosing Wisely, which offers guidance to doctors about which tests may be unnecessary in certain situations.

The primary goal for future medical liability reform is to find original ways to address the root of defensive medicine while ensuring the patient receives proper care.