Defensive medicine documented

via KevinMD and White Coat Notes – MMS First-of-its-kind Survey of Physicians Shows Extent and Cost of the Practice of Defensive Medicine and its Multiple Effects of Health Care on the State

“This survey clearly shows that the fear of medical liability is a serious burden on health care,” said Dr. Sethi. “The fear of being sued is driving physicians to defensive medicine and dramatically increasing health care costs. This poses a critical issue, as soaring costs are the biggest threat to the success of Massachusetts health reform efforts.”

7 tests and procedures Physicians were asked about their use of seven tests and procedures: plain film X-rays, CT Scans, Magnetic Resonance Imaging (MRIs), ultrasounds, laboratory testing, specialty referrals and consultations, and hospital admissions. The results were self-reported by the physicians responding to the survey.

The results showed that 83 percent of the physicians surveyed reported practicing defensive medicine and that an average of 18 to 28 percent of tests, procedures, referrals and consultations and 13 percent of hospitalizations were ordered for defensive reasons.

Cost is in Billions Sethi and Aseltine estimated the costs of the tests to be $281 million for the eight specialties surveyed, based on Medicare reimbursements rates in Massachusetts for 2005-2006. In addition, the cost of unnecessary hospital admissions was estimated to be $1.1 billion, for a combined total estimate of nearly $1.4 billion. The authors said the dollar estimates do not include tests and diagnostic procedures ordered by physicians in other specialties, observation admissions to hospitals, specialty referrals and consultations, or unnecessary prescriptions. The eight specialties represented in the survey account for only 46 percent of the physicians in the state.

Now I break for a public service announcement.  Check this rant for outrage from malpractice lawyers.

Malpractice reform can slowly change this problem.  We, physicians, would have to change our mindset about test ordering.  Fear of malpractice has a costly negative effect on health care.  We could practice better medicine if we had a healthier legal climate.

As long time readers of this blog know, I favor special health courts which protect patients and physicians. 

As we prepare to attack health care reform, I hope that the administration will include malpractice reform.  Malpractice reform is the single best way to decrease health care costs without decreasing necessary services.  In fact, malpractice reform will improve health care access.