Archives: September 2017

September 2017 Newsletter

Liability concerns drive up defensive medicine, cost of care Providing treatment above what is medically necessary to fend off the threat of a lawsuit continues to be a trend – and a major driver of health care cost increases. A study of over 2100 physicians conducted by Johns Hopkins University found that more than two-thirds of respondents believe that 15-30% of tests, procedures, and prescriptions were unnecessarily recommended. The reason? Liability concerns. Over 80% of the physicians surveyed cited the fear of medical liability lawsuits as the justification for practicing defensive medicine. “Addressing overtreatment can have a major impact on rising healthcare costs in the U.S.,” the authors wrote. “Using the Institute of Medicine’s estimate of excess costs arising from overtreatment, a 50% reduction in ‘unnecessary services’ would result in $105 billion in savings each year, or about 4% of total national healthcare spending.” With a patchwork of laws leaving uncertainty about the liability climate from state to state, physicians surveyed recommended a series of changes that could help in the interim, including improved training on appropriate criteria for care, more accessible medical records, and evidence-based practice guidelines. To read more about the Johns Hopkins study on defensive medicine, click…

Read More

Physicians Say Up to 30% of Treatment Unnecessary

Despite years of emphasis on curbing costly and potentially harmful unnecessary care, physicians believe that overtreatment remains an ongoing problem, according to research from Johns Hopkins University published this week in the journal PLOS ONE. The findings, based on a survey of 2,106 physicians, revealed that most of those surveyed (64.7%) believe that at least 15% to 30% of medical care is unnecessary. Participants were from a subgroup of the American Medical Association’s Physician Masterfile. The top three “culprits” cited were: Tests (24.9%) Prescription medications (22%) Procedures (11.1%) “Unnecessary medical care is a leading driver of the higher health insurance premiums affecting every American,” said the study’s senior author, Martin Makary, MD, MPH, professor of surgery and health policy Johns Hopkins. Makary and colleagues also collected physicians’ opinions as to why overtreatment occurs, and found the following perceived reasons: Fear of malpractice (84.7%) Patient pressure/request (59%) Difficulty accessing medical records (38.2%) In addition, most respondents (70.8%) said they believed that physicians are more likely to perform unnecessary procedures when they profit from them. And most respondents believed that de-emphasizing fee-for-service physician compensation would reduce healthcare utilization and costs. The top three potential solutions for eliminating unnecessary services were: Training medical…

Read More

Advances in Patient Safety and Medical Liability

Research in patient safety and medical liability in recent years has widened our definition of these terms. Patient Safety improvement is no longer a preventive strategy to protect medical facilities from lawsuits—it is a serious and wide-reaching effort to measurably improve the safety culture among staff in medical institutions, to find lasting and systemic prevention strategies for adverse events, and to work with patients—and with their families and caregivers—as equals to both address their care needs and to earnestly reconcile when their care does not go as planned. Working with patients as partners has become increasingly important in our rapidly changing medical landscape. Patients are experts in their own care and their own needs. Too often, we medical professionals ignore their expertise and opinion. In addition, caregivers and family members have knowledge and perspectives about the patient and his or her condition that can contribute to better care and improved patient safety. Transparency between and among medical colleagues and a supportive just culture are also central aspects to improving safety and creating a climate less prone to medical liability in health care facilities. The articles included in this publication demonstrate a wide variety of studies that investigate the importance of openness and…

Read More

Brace Yourself for an Ob/Gyn Shortage by 2020

Depending on where you live in the United States, it could already be tough to find an obstetrician/gynecologist—almost half of U.S. counties lack one, according to the U.S. Bureau of Labor Statistics. But recent studies show that the problem is only going to get worse, with some cities at risk for a severe shortage in the coming years. In July, Doximity, a social networking site for health care providers, released a study identifying 10 metropolitan areas that are most at risk for an ob/gyn shortage. After surveying 30,000 ob/gyns across the country and considering their age and workload, they found that the top five cities deemed most “at risk” are Las Vegas; Orlando, Florida; Los Angeles; Miami; and Riverside, California. Doximity’s study is hardly the only research on the shortage. The American College of Obstetrics and Gynecologists (ACOG) recently estimated that by 2020, there will be up to 8,000 fewer ob/gyns than needed across the country. “One of the reasons we put this report together was because of anecdotal stuff we were hearing,” Joel Davis, vice president of strategic analytics and growth at Doximity, tells SELF. “We wanted to bring transparency to the trend, because through that, policy decisions can be made. It can take…

Read More