In 2010, Congressman Tom Price coined the term “defensive medicine” to describe how doctors’ fear of being sued resulted in more diagnostic tests and healthcare spending. Since then, researchers have been exploring whether a fear of a medical malpractice lawsuit does, in fact, result in doctors ordering extra tests. If so, are these tests really necessary? Do they improve healthcare and health outcomes?
Read on to explore these questions, what research has to say about defensive medicine, and what you can do to protect your health and legal rights. If you have questions about malpractice lawsuits or care you received in a doctor’s office or hospital, contact Brown & Brothers to speak with one of our attorneys.
Does Defensive Medicine Result in Doctors Ordering Extra Tests?
When Congressman Price coined the term “defensive medicine”, he claimed to know the real reason why healthcare costs had risen so high. According to Price, defensive medicine cost the United States around $650 billion every year, or about 26 percent of each dollar spent. The incredible estimate resulted in several researchers exploring the idea of defensive medicine, as well as what impact it may have on the healthcare system and health-related costs.
The relationship between doctors and the medical malpractice system has long been tense. Doctors claim that the system “forces” them to order extra, or unnecessary, tests in order to protect themselves if a patient decides to sue. Unfortunately, it is difficult to really examine whether or not this is the case because there is no real control group to compare. Patients all across the U.S. can sue for medical malpractice.
Researchers from M.I.T. and Duke University have, however, studied a “pocket” of America, which resulted in one of the more precise estimates of defensive medicine and its impact on the healthcare system – Hospitals. According to one recent study published by the National Bureau of Economic Research, defensive medicine is very real, but is not the only factor driving up healthcare costs.
Researchers also discovered a positive correlation between the possibility of a lawsuit and the amount of diagnostics and care received by patients. To reach this conclusion, researchers studied active-duty military personnel in the hospital setting. U.S. law allows active-duty personnel the benefit of government healthcare, but they are barred from suing a government hospital or doctor for medical malpractice. Their family members, however, are allowed to sue.
The study examined what happened when military members were forced to use civilian hospitals due to a base closing. In this environment, the military member would be allowed to sue because the hospital and doctors were not owned or operated by the government. Researchers noted that in civilian hospitals, the cost of healthcare increased, with the majority of spending related to diagnostic testing. Further, military family members – who are allowed to sue both military and civilian hospitals and doctors – received more tests overall than patients not allowed to sue.
Are Extra Tests Really Necessary, and Do They Improve Healthcare and Outcomes?
Researchers considered a variety of quality indicators in their study and found no indication that the quality of care provided in the military hospitals differed from the quality in civilian hospitals. They considered factors like cutting corners, and various measures of quality and care. Researchers found that the possibility of being sued increased the intensity of healthcare in the hospital setting by around five percent.
Even with more intensive care, patients were no better off than their counterparts who received standard care. The findings of the study suggest that healthcare providers may change their behavior due to liability considerations, but that those changes are not necessarily making their patients any healthier.
Like most research, this study has limitations. For example, this study focuses only on one demographic in the hospital setting, and there are numerous variables that may factor into healthcare behavior. Research like this is important in order to identify and clarify issues impacting the healthcare system.
The Medical Malpractice Environment
Patients in most jurisdictions in the U.S. are legally allowed to sue a doctor for medical malpractice. Doing so can impact a doctor’s license, position, liability insurance, and ability to practice. While these are serious concerns, they pale in comparison to the damage that can be done to a patient and his or her loved ones if they are injured by substandard care.
Many states have proposed laws to limit liability, place caps on the amount a case can be “worth”, or to eliminate malpractice entirely. These proposals are often viewed as unrealistic. More realistic reforms would include measures that generate social value (protecting patients, reducing costs, etc.) and lower the burden placed on healthcare providers. To reach realistic reform, more research is needed on the relationship between liability and malpractice pressures and quality of care.
Get Help with Your Medical Malpractice Case
Until there is more clarity in the relationship between malpractice pressure and quality of care, it is important that patients understand their legal rights and be their own best advocates. As a patient, there are a few things you can do to ensure you are getting the best quality, and most effective, healthcare possible. Consider these tips:
- Research your symptoms so you fully understand them.
- Talk to your doctor about any diagnostic tests, why they are needed, and whether they are useful.
- If you feel uncomfortable with the tests your doctor recommends, get a second opinion about your symptoms and possible diagnoses.
- Remember that you do not have to undergo any procedure or test unless you agree to do so and sign applicable paperwork.
If at any time you have concerns about the diagnostic process, the tests that were ordered, or the quality of care your healthcare provided, don’t be afraid to speak up. You are your own best advocate and you have the right to receive care that is high quality and in accordance with medical and legal standards.
To learn more about your legal rights, contact Brown & Brothers by filling out our online form. We will contact you as soon as possible to schedule a free consultation between you and one of our skilled attorneys.