Defensive medicine may cost the industry billions
Doctors are using “defensive medicine” as a way to avoid medical malpractice lawsuits, a policy some believe is increasing healthcare costs.
According to a series of physician surveys from Alpharetta, Ga.-based Jackson Healthcare, the root problem driving defensive medicine practices is that physicians’ livelihoods are at stake.
“The U.S. is the only major country in the world where physicians are personally financially liable for mistakes,” said Richard Jackson, chairman and CEO of Jackson Healthcare. “Older physicians are sharing lawsuit stories and advice with younger physicians. These stories are convincing younger physicians to practice defensive medicine.”
According to the Centers for Medicare and Medicaid Services, healthcare in America costs $2.5 trillion annually. Based on the results of one of the Jackson Healthcare surveys, conducted by Gallup, it is estimated that $650 billion of that is spent on unnecessary tests and treatments.
“Healthcare would be cheaper for every American if we could slash the cost of defensive medicine,” said Newt Gingrich, founder of the Center for Health Transformation. “Think of how often each of us gets sent for extra lab work or tests that seem so unnecessary."
With each passing decade, the Jackson surveys suggest, defensive medicine is growing in prominence and practice. This method of practice is being passed down by seasoned doctors and taught in medical schools.
About 83 percent of survey respondents aged 25-34 reported being taught defensive medicine during their medical residencies, compared to just 19 percent of respondents aged 65 and older.
Another study in the series shows that physicians use defensive medicine because they don’t feel they have as much control in the way they practice medicine as they did five years ago. In this survey, 85 percent of respondents said the threat of medical malpractice litigation affects their ability to deliver care. Other factors, they said, include insurance and government interference.
“We found that... the (survey) respondents attributed the practice of defensive medicine to excessive waste in the healthcare system,” said Jackson.
The Center for Health Transformation has suggested addressing civil justice reform – or discouraging frivolous lawsuits – through several means, including health courts that only consider medical malpractice cases.
“That kind of money could certainly help pay for the healthcare of many uninsured Americans,” Jackson said. “If we eliminate defensive medicine, we can make healthcare more affordable for everyone.”
The Jackson Healthcare studies also found that defensive medicine is negatively impacting physicians and patients beyond costs. It is limiting patient access and quality, slowing the adoption of medical innovations and may be discouraging future generations from pursuing the practice of medicine.
Fifty-three percent of survey respondents say they delayed adopting medical innovations such as new pharmaceuticals, procedures and medical devices due to fear of litigation.
According to the survey, surgery sub-specialists (66 percent) and OB/GYNs (63 percent) are most likely to delay the adoption of medical innovations, while pediatricians (27 percent) are least likely to do so.
“I practice defensive medicine by avoiding the practice of those procedures which might benefit my patients but are considered too risky by my malpractice insurer and would increase my premiums to a degree that is prohibitive,” said one physician, who cited joint injections as an example.
