Doctors that are afraid of legal backlash are much more likely to order unnecessary tests and hospitalization, according to a new study published this week in JAMA Internal Medicine.
Defensive medicine – a euphemistic term for this practice – is estimated to cost the U.S. more than $46 billion each year.
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Almost a third of the orders were found to be defensive to some degree, according to the study. Among these partially defensive orders, the vast majority of costs came from unnecessary hospitalization, with a significant minority attributable to an overuse in diagnostic tests.
“Some people might say it’s defensive, and other people might think it’s the standard of care,” Dr. Michael Rothberg, vice chair for research in the Medicine Institute of the Cleveland Clinic and lead author of the study, said in an interview with Modern Healthcare. “There’s really more of a culture about how people treat a particular problem, and many may not recognize it as being defensive.”
The mean cost per patient was $1,695, of which $226 was defensive. But overall, only about 3 percent of all costs were considered completely defensive – that is, they were directly attributable to a fear of legal repercussion.
The study surveyed 36 doctors at three Massachusetts health systems. The docs rated 4,215 orders for 769 patients.
