Malpractice Concerns Predict Aggressive Testing

A new study shows that physicians' concerns about malpractice risk forecast more intense diagnostic testing practices in office-based care.

Researchers at the US Center for Studying Health System Change (Washington DC, USA) conducted a study to assess physicians’ perceived malpractice risk, following widespread agreement that physicians who practice defensive medicine drive up health care costs. To do so, the researchers linked physicians’ responses regarding their levels of malpractice concern (as reported in the 2008 Health Tracking Physician Survey) to Medicare Parts A and B claims for the patients the same doctors treated between 2007 and 2009.

The researchers found that physicians who reported a high level of malpractice concern were most likely to engage in practices that would be considered defensive. This was seen in diagnosing practices for patients who visited their offices with new complaints of chest pain, headache, or lower back pain. There was no consistent relationship seen when state-level indicators of malpractice risk replaced self-rated concern. The study was published in the August 2013 issue of Health Affairs.

"Reducing defensive medicine may require approaches focused on physicians' perceptions of legal risk and the underlying factors driving those perceptions,” concluded lead author Emily Carrier, MD.

Medical malpractice is professional negligence (by act or omission) by a health care provider, in which the treatment provided falls below the accepted standard of practice in the medical community and causes injury or death to the patient, usually involving medical error. Standards and regulations for medical malpractice vary by country and jurisdiction within countries. Approximately 195,000 people are killed every year by medical errors in the United States alone, leading to 15,000-19,000 malpractice suits brought against doctors.

Related Links:
US Center for Studying Health System Change