This link between “defensive medicine” and malpractice risk merits further research, experts say. Defensive medicine is estimated to cost the U.S.as much as $50 billion annually and that number is only going to go higher in an Obamacare world, where health care can now bring the full force of federal prosecution down on any mistake. The term defensive medicine means offering care to decrease the risk of being sued for malpractice, and not improve treatment.
Advertisement
Researchers looked at data from almost 19 million Florida hospital admissions between 2000 and 2009 and malpractice claims against 24,637 doctors in seven specialties.
For example, in internal medicine, the probability of experiencing an alleged malpractice incident in the following year ranged from 1.5% in the bottom spending fifth ($19,725 per hospital admission) to 0.3% in the top fifth ($39,379 per hospital admission).
Prior work by Jena and co-author Seth Seabury, a Fellow at the Schaeffer Center and associate professor of clinical emergency medicine at the Keck School of Medicine at USC, has found that the typical physician spends almost 11 percent of their career with an open malpractice claim and that in high-risk specialties, the lifetime risk of being sued is almost 100 percent. Insurance companies and payers are looking to cut back on unnecessary spending to reduce costs and lower insurance premiums, and doctors are looking to provide the best care for their patients, while also protecting themselves from malpractice suits.
They conclude that more evidence on rates of errors associated with greater spending is needed.
To be more specific, the study found that as annual hospital spending (per physician year) increased, malpractice rates dropped.
The gynecology and obstetrics malpractice claims returned a 4 percent per doctor.
Similar findings were seen in C-section rates among obstetricians.
The study did not account for situations in which a doctor might avoid treating a patient because he or she represents a high liability risk.
This is an important question that explores the contentious issues of defensive medicine and malpractice risk in the USA healthcare system, write Tara Bishop and Michael Pesko at Weill Cornell Medicine, New York in an accompanying editorial. Moreover, whether higher levels of spending were defensively motivated by malpractice concerns is still unknown. Instead, “we should consider Jena and colleagues’ study as a contribution to our understanding of malpractice risk”.
Advertisement
Researchers in the new study suggest that doctors conduct defensive medicine, which can include anything from extra blood tests and scans to opting for cesarean section more often, because they believe the procedures show the great length gone to avoid life-threatening errors – which can help with patients, and in front of judges and juries.
