According to a study published on November 4, 2015, by the British Medical Journal, medical professionals who spend more resources, time and money on patient tests and procedures, generally get sued less for malpractice / negligence. The study was conducted by a team of researchers from Harvard Medical School, Stanford University and the University of Southern California. The researchers state that “defensive medicine” means “doing more for patients because they believe it reduces liability risk.”
Defensive Medicine can Undermine Healthcare Reforms
According to Seth Seabury, one of the authors on the study from the University of Southern California Schaeffer Center for Health Policy and Economics, this lower risk of malpractice liability could undermine healthcare reforms. The reforms rely on medical professionals to eliminate wasteful spending in healthcare. However, if the medical professionals start believing that reducing spending might make them more vulnerable to malpractice suits; they will have no incentive to do so.
Data Collected for the Study
Analyzing data from Florida hospitals and malpractice cases, the study confirmed that medical professionals use defensive medicine and that it does protect them from liability. 24,637 physicians, 154,725 physician years and 18,352,391 hospital admissions were involved in the data collection, along with information gathered from 4,342 malpractice claims. The study found that across specialties, greater average spending by physicians was associated with reduced risk of malpractice claims. Among interns, the probability of an alleged malpractice incident ranged from 1.5% in the bottom spending fifth to 0.3% in the top spending fifth. The researchers focused on obstetrics, gathering information from admissions to Florida acute care hospitals between 2000 and 2009, where according to them, the choice of caesarean deliveries was influenced in large by defensive medicine.
The Dangers of Defensive Medicine
According to Tomas J Philipson, professor of Public Policy Studies at the University of Chicago and a healthcare director at the Becker Friedman Institute, the study raises important questions about the costs and benefits of the medical malpractice system. While it makes medical professionals spend more to avoid liability, this liability comes from bad health outcomes and thus must be weighed against the improvements in patient health that this spending enables – how productive is this additional spending in terms of improving patient outcomes.
According to some professionals in the healthcare industry, defensive medicine has become necessary despite the harm caused by it in the long term. Dennis Hursh, managing partner of Pennsylvania physician’s law firm Hursh&Hursh PC, feels that defensive medicine is absolutely required to protect physicians from an out of control judicial system. According to him, healthcare professionals feel forced to order tests and procedures despite knowing that they will be of marginal value to the patient as any failure to do so might invite a malpractice suit. He feels that many physicians would forgo these tests and procedures that do not benefit the patient if they did not have the threat of being second guessed by lawyers and judges.
John R Patrick, author of Health Attitude: Unraveling and Solving the Complexities of Healthcare, does not find the outcome of the study surprising. He believes that it is a logical conclusion, but not necessarily a good thing. Defensive medicine is driving up the cost of healthcare and with 10,000 people turning 65 years of age everyday and joining Medicare, the cost of current spending per person is becoming prohibitive. Studies have revealed that the cost of these unnecessary tests and procedures have reached up to $1.5 trillion. At this given rate the country will go bankrupt if heath care spending is not reduced.
- University of Southern California, Harvard Medical School and Stanford University. (2015). More Doctor Spending Linked to Fewer Malpractice Risks. British Medical Journal.