An internet television program that explores the intersection of medicine and the law.

Does Defensive Medicine "Work"?

By Dr. Anupam Jena to Defensive Medicine


Does Defensive Medicine "Work"?

Our guest on Healthcare Matters is Anupam B. Jena, MD, PhD, one of the authors of the study Physician spending and subsequent risks of malpractice claims: an observational study, which was published in The BMJ in November 2015. Dr. Jena sat down with Healthcare Matters to discuss the study's results, methods and limitations as well as its implications for research on defensive medicine and healthcare spending. Dr. Jena details how the study shows a correlation between increases in physician spending and a lower likelihood for that physician to be subsequently sued for malpractice. Though the study has several limitations which are addressed during the interview, it helps to shed light on important aspects of healthcare spending, the doctor-patient relationship and the difference between appropriate healthcare spending and defensive medicine. In Part I of our interview, we ask Dr. Jena to talk about his initial research question and whether or not defensive medicine 'works'. This is the first part of our interview with Dr. Jena. To see the entire video, click here. To view each portion of the interview separately, please use the links below.

  1. Does Defensive Medicine "Work"?
  2. Greater use of Resources vs. Defensive Medicine: What's the Difference?
  3. The Link between Physician Spending and Medical Malpractice Claims
  4. Medical Malpractice Claims and the Doctor-Patient Relationship
  5. Physician Spending, Patient Outcomes and Future Research
  6. How can we differentiate between defensive medicine and “good” medicine?
  7. Fee-for-Service vs. Outcome-Based Models and the Effect on Healthcare Costs
  8. Could Defensive Medicine Actually Lower Medical Malpractice Claims?
This interview is brought to you by Cunningham Group, the Medical Malpractice Insurance Specialists.


Mike Matray: Dr. Jena you’re here to discuss an observational study you conducted on physician spending and subsequent risk of malpractice claims, which was published last year in the BMJ Medical journal. A good place to start would be what was your initial study question and methods?

Dr. Jena: So defensive medicine is reported to be practiced by somewhere between 60% and 90% of physicians, if you look at surveys. And what defensive medicine means is it’s the ordering of tests and procedures solely to reduce the threat of malpractice liability. And there have been a number of studies which look at whether or not doctors in fact order more tests and procedures because they’re worried about liability threats. But there really has not been any work to understand whether or not it’s even possible that defensive medicine could “work,” meaning that if a doctor orders more tests and procedures, is he or she less likely to get sued? And that was a question that we set out to answer.