Lawyer: "I want my doctor to use defensive medicine"

February 20, 2007

Some honesty from the legal profession by acknowledging the presence of defensive medicine. Kudos to this attorney for telling us what he really wants – frequent and expensive tests, no matter what the cost:

I want my doctor to use defensive medicine. I want them to use anything available to make sure they are on the right track. When you are talking about a member of your family, your child, you don’t want a doctor taking shortcuts on some diagnostic test. It’s just like a recent case where a patient went into the hospital because he had a fall and hurt his neck and they didn’t X-ray. The next morning he woke up paralyzed from the neck down. They saved the cost of that X-ray, but the result is catastrophic because that person is paralyzed for the rest of his life.

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Tagged as: hospital, malpractice, patient

{ 8 comments }

1 Anonymous February 20, 2007 at 3:49 pm: Kevin, you do realize he’s using a different definition than you of defensive medicine, don’t you?
2 Anonymous February 20, 2007 at 6:21 pm: Everyone wants everything when it is themselves or their family. The trouble has to do with who is paying the freight.
3 Gasman February 20, 2007 at 6:56 pm: Nurse, get me the BIG proctoscope…
4 AleS February 20, 2007 at 7:34 pm: Surely he wants it… but has he already deserved it? And it’s normal, all should be in harmony, what have you made for it? – that’s a question

As said gasman “BIG” question
5 Anonymous February 20, 2007 at 7:50 pm: Everyone wants everything when it is themselves or their family. The trouble has to do with who is paying the freight.

I think the reason this lawyer and the like want “defensive medicine” is that they don’t understand that it is not just about the money and that tests have risks too. So maybe if you guys put more effort in educating public, than maybe there’ll be fewer people sharing this lawyer’s sentiments.

Also, we don’t really know much about the details of the case this lawyer cites to determine if his definition of defensive medicine is the same.
6 Anonymous February 21, 2007 at 5:36 pm: I frequently hear, “that tests have risks too.” Does anyone know what, statistically speaking, are these feared risks for the top 10 most often ordered tests, both inpatient and outpatient?
7 Anonymous February 21, 2007 at 7:31 pm: Once again this makes obvious the problems created when the payment for an individual private good, healthcare, is collectivized.
8 Anonymous February 22, 2007 at 12:55 pm: Anon at 5:36, this has been discussed ad nauseum. If you are interested, you can look it up yourself.

Select a test, say, cat scan and look up the amount of radiation and chance it can cause cancer some years down the line. Check it up for kids. Keep in mind that the effect of radiation is cumulative. Now think about how high a chance that you have some condition you want the doctor to test your kid for must be like for you to accept this risk. Do the same for multiple X-rays for kids.

Select any other test you like and look up the percentage of false positives. Look up what test(s) is/are likely to be done in case of a false positive and the chance of complications from a riskier test (I believe there was some mention of EKG sometime in this forum last year with actual numbers). Multiply the risk of false positive by the risk of complications from additional test(s). Here is your risk of suffering harm if you take the test in the first place.

For other tests, like PSA, go to NIH or USPSTF websites and look up “harms of testing”. Also look up “overdiagnosis”.

Keep in mind that risks go up with the number of tests.

Now consider the chance you have the desease the doctor is testing you for. Keep in mind that when they talk about “defensive” testing they mean cases in which your chance of having this desease is really small. Think about how much risk you are willing to tolerate for say 1/10,000 chance of benefit.