‘Defensive Medicine’ Could Lead to Fewer Errors, Malpractice Claims

Physicians with higher patient costs have a lower risk of future liability claims, suggesting that "defensive medicine" practices could reduce errors and consequently malpractice lawsuits, according to a study conducted by researchers from institutions in California and other states, Modern Healthcare's "Vital Signs" reports.

Such defensive medicine practices involve ordering costly and sometimes unnecessary tests or treatments, and they are used to protect physicians from being sued. However, they also can add billions of dollars to U.S. health care costs.

Details of Study

The study was conducted by researchers from:

• Harvard Medical School;
• The National Bureau of Economic Research;
• Stanford University School of Medicine; and
• The University of Southern California's Center for Health Policy and Economics.

The researchers examined data on more than 18 million hospital admissions among 24,637 physicians at acute care hospitals in Florida. The study included seven specialties:

• General surgery;
• General surgery subspecialty;
• Internal medicine;
• Internal medicine subspecialty;
• Family medicine;
• Pediatrics; and
• Obstetrics and gynecology (Rice, "Vital Signs," Modern Healthcare, 11/5).

Findings

According to the study, physicians who provided the costliest care between 2000 and 2009 were the least likely to be sued between 2001 and 2010 (Latinos Health, 11/6).

For example, a general surgeon whose patients averaged about $52,000 in costs had a 0.4% chance of being sued. In comparison, a general surgeon whose per-patient costs averaged $25,000 faced a 2.3% chance of being sued.

The researchers noted that more information would be needed to determine whether the higher costs were incurred because of defensive medicine practices.

They concluded, "More frequent consultations and increased diagnostic testing could, in theory, reduce diagnostic errors, which are the leading cause of malpractice claims," adding that higher upfront costs could be a "socially beneficial deterrence" if the costs lead to fewer errors and malpractice claims ("Vital Signs," Modern Healthcare, 11/5).