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)