More defensive medicine: A study suggests that the fear of lawsuits is leading to more hospital admissions
This is stating the obvious and merely an extension of over-ordering tests:
Emergency room doctors who are the most fearful of malpractice suits are more likely than their colleagues to order tests and admit patients for chest pain or other heart symptoms, according to a study led by a University of Iowa researcher.
The study found that such doctors admit even those patients who are low risks for actual problems, said Dr. David Katz, an associate professor of internal medicine at Iowa.
The findings were based on a surveys of 33 emergency room doctors who participated in a study of 1,134 patients at two teaching hospitals. The results appear in the July 13 online issue of the Annals of Emergency Medicine.
Nearly 7 million Americans seek emergency care for heart-related symptoms each year, according to the university’s school of medicine. Almost half of those patients are admitted to the hospital, yet it’s later found that most did not have a serious problem such as a heart attack or unstable angina.
A hospital admission can cost as high as $1200. Most everyone with chest pain are now admitted, their cardiac enzymes cycled, and then undergoes stress testing the next day.
Is this good medicine? Well, that is debatable and beside the point. This is today’s reality. All it takes is sending one “low-risk” patient home who later has a heart attack that will generate a lawsuit. Most will accept a $1200 admission every time rather than risk being sued.
I have been asked to back up my last statement, where “low-risk” patients sent home who later have a heart attack will generate a lawsuit. Here is one case:
On April 19, 1980, Phillip was treated at the St. Luke’s emergency room on two separate occasions, once at 12:22 a.m. and again later that day at 10:55 p.m. On the first occasion, Phillip sought treatment at the emergency room for chest pain. He was examined by Doctor Ellison, tests were performed, and he was then sent home. Later that day, Phillip was brought to the emergency room in an ambulance with symptoms of chest pain. He was again examined by Dr. Ellison and more tests were performed. Dr. Ellison conferred by telephone with Dr. Ehlen, Phillip’s personal physician, and Phillip was again sent home.
Within eight hours after Phillip’s second visit to the St. Luke’s emergency room, he experienced a heart attack at home and was taken by ambulance to St. Ansgar Hospital in Moorhead where he was attended by Dr. Carlisle. Phillip sustained severe injuries, including brain damage, as a result of the heart attack.
Phillip and Dorothy filed an action against the defendants alleging that, by failing to hospitalize and continue observation of Phillip, the defendants violated applicable standards of care causing Phillip’s serious injuries and resulting damages.
The jury found for the defense, but the point was, a lawsuit was generated.