Differing malpractice views

Medscape with a nice article on the divergent malpractice views by the candidates:

Skyrocketing malpractice premiums have forced physicians to perform additional tests and procedures they might not need to, driving up federal costs by $28 billion a year, Bush told audiences attending debates in Tempe, Arizona, on Oct. 13 and in St. Louis, Missouri, on Oct. 8. Enacting tort reform with a $250,000 limit on payment for noneconomic damages would put a needed brake on rising premiums and lower health costs, according to Bush. A malpractice reform bill passed the U.S. House last year but has been blocked in the Senate.

Kerry, on the other hand, countered that malpractice costs account for less than 1% of total healthcare costs. “Now, ladies and gentlemen, important to understand, the president and his friends try to make a big deal out of it,” Kerry said during the Oct. 8 debate. “Is it a problem? Yes, it’s a problem. Do we need to fix it, particularly for ob-gynes and for brain surgeons and others? Yes.”

I take issue with the 1% of total healthcare costs figure, because of the practice of defensive medicine. However, the article points out that effects of defensive medicine may be exaggerated:

As to Bush’s claim about the additional costs of defensive medicine, the evidence is “very mixed,” with “little solid research about whether having noneconomic damages limited the effect of defensive medicine,” said Paul Ginsburg, PhD, president of the Center for Studying Health System Change, a nonpartisan health research organization in Washington, D.C. Given the limited and contradictory evidence, “CBO is not willing to attribute any savings [from malpractice reform] to reductions in defensive medicine,” Dr. Ginsburg told Medscape.

I can’t quote any numbers, but from my experience, defensive medicine certainly pervades medical practice today. There are countless times when unnecessary tests are ordered to cover yourself. Take these cases, for instance. The impact a lawsuit threat has on a physician’s decision making skills simply cannot be discounted.

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  • Anonymous

    It’s not just extra tests, either. I’ve seen plenty of times when a patient was kept in the unit because the family was making a stink. Tack on an extra 1000$ per day on the hospital bill every time it happens.

  • Anonymous

    Defensive medicine clearly costs a fortune.

    Unfortunately, limiting things like non-economic compensation will do nothing to reduce defensive medicine. As long as there is a climate in which lawsuits for malpractice are common, defensive medicine will flourish.

    Whether or not I think that a patient would reap a windfall from pain-and-suffering would not influence my ordering of a ct scan. Nor would the level of my malpractice premiums. Only my perception of the risk of being sued could influence the extent of my ordering defensive tests. And this is unlikely to be affected much by most tort reform.


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