The State of Defensive Medicine Infographic
Defensive medicine is notoriously hard to quantify, with estimates of the cost to the U.S. healthcare system ranging anywhere between $46 billion and $850 billion. Yet, it is a pervasive part of the medical system. To complement the Healthcare Matters interview series, The State of Defensive Medicine, featuring Richard E. Anderson, MD, FACP, Chairman and CEO of The Doctors Company, we have created an infographic, which offers some interesting insight into defensive medicine and how it permeates the healthcare system.
Dr. Anderson’s definition of defensive medicine as “…a test, procedure or therapy that is ordered by the physician primarily to protect himself or herself from liability rather than because of its diagnostic or therapeutic utility,” provides a starting point for understanding defensive medicine, but it is not enough to define the concept. To see the effect that defensive medicine has on the healthcare system, we must look at what physicians themselves say about the practice of defensive medicine, whether or not they do it, and, if so, why.
In surveys, the vast majority of all physicians (73 percent) say they practice defensive medicine. Even higher rates are found among specialists, at 93 percent. Perhaps most disturbing is that, in one study, 45 percent of medical students and residents said that they were taught to practice defensive medicine in medical school or residency programs.
In today’s ever-changing healthcare system, physicians have many reasons to be worried about patient care, and whether a bad outcome could lead to a lawsuit. In a survey of general practitioners, the top reason for practicing defensive medicine was malpractice concerns, which was cited by 76% of respondents. Other responses were to meet clinical outcomes (52 percent) and because the physicians felt that they had too little time to spend with patients (40 percent).
Defensive medicine has a great impact on all physicians, but it has an especially high impact on specialists, such as surgeons and OBGYNs. These specialists are involved in high-risk procedures, and may be more likely to face lawsuits. In one survey of neurosurgeons, for example, more than 69 percent said that they viewed every patient as a potential lawsuit. This has many potential consequences, like ordering additional tests (67 percent), imaging studies (72 percent), medications (40 percent) and referrals (66 percent), which is wasteful and time-consuming. In this climate, many neurosurgeons (45 percent) have decided to stop doing high-risk procedures entirely.
Defensive medicine is a difficult problem to solve, and the first step is understanding the scope and depth of the problem. To learn more about defensive medicine and its impact on the healthcare system, watch our new Healthcare Matters series, The State of Defensive Medicine.