An ER physician talks defensive medicine.
So it makes me a little crazy when it’s claimed that doctors aren’t motivated by fear of lawsuits — we are. Now if you want to claim that the overall fraction of healthcare dollars spent on defensive practice is low — 1-2% of all spending — I might agree with that. But bear in mind that the healthcare expenses in the US are in the trillions of dollars, so we are talking many billions spent on unnecessary care. If you want to argue that tort reform won’t change doctor’s practice patterns, I would be open to the possibility — doctors don’t want to be in the NPDB whether it’s for a million dollars or for fifty thousand. But don’t tell me that defensive medicine doesn’t exist.
So true. It doesn’t matter whether defensive medicine “works” in preventing lawsuits or not. You can never design a study to prove that. All that matters is the physicians’ perception of the lawsuit threat. If the perceived threat is there, defensive medicine will continue to run rampant.
The solution? No-fault malpractice, health courts, caps – it doesn’t matter. Any one of these options will go a long way in reducing the perceived malpractice threat, and subsequently decrease the amount of defensive medicine. That’s the reality. (via Grand Rounds)
Related posts:
- Former med-mal lawyer: "Fewer than 10 percent of cases were the doctors fault"
- Consumerism and health quality
- Why do doctors practice defensive medicine?
- Dr. SSS: The two most expensive words in medicine
- Physicians don’t trust the malpractice system and why doctors order too many tests
- Defensive medicine op-ed reaction
- Defensive medicine in the news
KevinMD.com on Facebook
{ 60 comments }
← Previous Comments
Why, looking for a date?
Jeez, I thought flea was a woman.
Is anybody actually reading anybody elses posts?
The point of my post at 10:46 AM post yesterday was a rebuttal of the suggestion that docs do not practice DM.
The fact that I was awakened has nothing to with lack of respect for ER docs and stems from the fact that the call was of a non-urgent nature (”could you follow up on this in the AM?”) and could have been left on my voice mail.
And where did everybody get the idea:
1. That I’m a bad doctor because I’ve been sued twice? Is the proposition currently on the floor that “suit = mistake”?
2. Where did I indicate that I was proud of these suits? If I were I’d use my real identity. Would any of you discuss pending suits and use your real names?
3. What does CJD mean and why should I care if I’m in the same category?
best (really!)
Flea
CJD is a med mal lawyer who posts on this site. He will commonly use the term “anonymouse” to describe anyone else who doesn’t sign their post with letters, implying that he is accountable by using those letters, but others aren’t. Obviously people can be more honest (and rude) if they don’t leave their real name.
b
Actually, I’m not a med mal lawyer. I use the anonymouse phrase when they all start hurling insults and I can’t keep them straight.
CJD
Yes, I also thought flea was a woman. and as for “Why, are you looking for a date?” Nah, my husband won’t tolerate it, but if that is flea in that picture, he is hot!
CJD = Cares (about) Just Dollars
Gee, guys, I come to this one a day or two late. But I could feel the heat of the comments over here in the UK.
I have been a GP for twenty years, and I have never been sued. Nor have any of my nine partners, so that is 120 years without a malpractice suit. Does that mean we are better docs than you guys? Of course not. It is environment, and it’s the courts, and yes, its those wretched lawyers.
Only recently have UK lawyers started working on a contingency, split the damages basis.
The UK courts however (I think mindful of the USA nightmare) are resolute in protecting doctors against the need to practice so called defensive medicine. In fact the expression “defensive medicine” is almost an oxymoron.
Defensive medicine means sujecting patients to unnecessary tests out of some misguided idea of “protecting” the doctor from litigation.
I am – and I do not use the word lightly – horrified to read the suggestion that every child presenting with a URI to the ER is routinely getting a CXR. I don’t know if someone has totted up the radiation doses here but we are moving from diagnostic radiology to therapeutic.
Flea’s practice seems to match with what we would do in the UK. Except I don’t think we would “routinely” do even an Hb on a fit child.
What a nightmare for you all.
Mind you, our medical insurance costs are rising.
For interest: as a full time GP I pay about £450 a month for full insurance cover – and that covers me for an UNLIMITED amount and as many claims as may be made. And that would cover interpartum obstetrics if I did it ( I don’t)
My wife, who is a diagnostic radiologist, pays £900 a month. That includes cover for interventional radiolgy, arteriograms, US guided biopsy etc etc
For both of us, this cover gives unlimited liability for as many claims as may arise (none yet, thank god) and, if there is a claim, the premium does not automatically go up.
How does that compare?
John
welcome to the wonderful f#$ked world of american medicine.
I say screw it. I paid $750k to Edwards company to settle a bs lawsuit for a brain damaged kid whose mother’s life I saved by emergency surgery. Half the money went up her nose and half to Edwards campaign fund. The insurance company was concerned about the possibility of a multi-million dollar award and I was too disgusted to care. Call me “former obstetrician” if anonyomous is too, well anonymous
← Previous Comments
Comments on this entry are closed.