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

The Link between Physician Spending and Medical Malpractice Claims

By Anupam B. Jena, MD, PhD to Defensive Medicine


The Link between Physician Spending and Medical Malpractice Claims

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 III of our interview, we ask Dr. Jena to talk about the link between physician spending and medical malpractice claims, which is detailed in his study. This is the third part of our interview with Dr. Jena. To see the full interview, 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: With hindsight, what was the most surprising or illuminating conclusion you and your associates found?

Dr. Jena: So I think the most interesting thing is that there appears to be this potential link between spending more and getting sued. There are a number of reasons why you might think that there should be a link. For instance, one might think that the reason that doctors get sued has very little to do with the number of tests or procedures that they order, but has more to do with the relationship that they have with the patient. And if that were the case, then we wouldn’t expect to see any relationship between the general level of spending of a doctor in his or her lawsuits. But none the less, we do find it. We do find that doctors who spend more get sued less often.

And so that certainly does suggest a possibility that spending could have a deterrent effect on suits, whether it be through a defensive mechanism, in which case patients may be less likely to sue a doctor because they thought that all exhaustive options were done, or whether it’s through a what I would call a “good medicine mechanism”, in which case better outcomes actually resulted in the doctor was sued less often.