There is an interesting debate going on at Medrants between Dr. Centor and a lawyer. The topic of defensive medicine came up:

Many physicians do order unnecessary tests. This phenomenon occurs most often in emergency rooms, but also occurs in office practice.

When does this occur? I do not have hard data (again db asks for help from the readers), but I believe that I see many unnecessary head CTs, cardiac catheterizations, abdominal CTs and back MRIs. These occur because medicine involves uncertainty. Many physicians practice CYA medicine.

All physicians know how to order these tests so that insurance companies will pay. Insurance companies would like to limit unnecessary testing – but the task is daunting.

The best example here is unnecessary procedures – especially C-sections. John Edwards almost singlehandedly increased the C-section rate with his cerebral palsy suits.

This has been echoed in multiple lawsuits that have been previously discussed. Simply put, the “art” of medicine no longer holds up in court. Physicians are held up to an impossible standard where 100% accuracy is demanded, which unfortunately leads to excessive testing and referrals. As Dr. Centor says, the upcoming referenda on malpractice will gauge if the public feels the same way about the malpractice crisis.