A recent study showed that 58% of responding physicians reported that they have, in the past year, ordered a test or procedure for defensive medicine reasons.
There is a prevalent argument in the health care industry that defensive medicine drives up health care cost and it seems logical but what really drives defensive medicine may be driving the cost more than the practice of defensive medicine itself.
There are times that a physician may be in a position to practice “defensive medicine” and order tests or treatments that might not be medically necessary in order to avoid being charged as negligent in a lawsuit. These tests or treatments drive up the cost of health care and impact the patient by requiring that the patient to spend time and money to undergo procedures that may not be necessary.
I don’t believe defensive medicine is really the problem, the problem is the might and may above. Sure, the threat of malpractice is a concern for physicians from both the perspective of cost and reputation and any attorney worth his or her salt will be able to make a case that a test or treatment that wasn’t ordered was medically necessary after an illness has been discovered and real tort reform would help to address this concern. (The discussion of tort reform deserves a blog all its own so I won’t get into it here)
I believe caution and clinical judgement are often confused with defensive medicine. Many times tests or treatments are ordered for a patient because there might be an outisde chance that a patient may have a specific disease process. If it’s my physician the might and may are important to me as a patient. If my physician believes I might have a problem that may affect my well-being, I’m perfectly fine with my physician erring on the side of good clinical judgement and ordering the test.