Conversation Starter: Effects of Defensive Medicine on Liability Claims

As the sky high cost of ordering more tests than is medically necessary further adds to the burden of an already expensive health care system, researchers in an initial study of defensive medicine opened the door to further analysis on how health care spending is linked to a reduction in liability lawsuits.

The British Medical Journal study, focusing on physicians practicing in Florida between 2000 and 2010, saw a correlation between individual physicians’ rapid rise in spending and their likelihood of being sued.

Among doctors in six out of seven specialties, those in the highest fifth of spending had the lowest rates of liability claims. Similar associations were seen among pediatricians, surgeons, and obstetricians, with no association noted for family physicians.

An editorial accompanying the study urges readers not to jump to conclusions that the cure for liability reform is in fact piling on unnecessary tests and procedures.

“It may be tempting for doctors to use the results to justify ordering unnecessary tests and procedures to reduce their risk of malpractice claims. Instead, we should consider Jena and colleagues’ study as a contribution to our understanding of the risk of such claims,” the editorial notes.4.

One important limitation of the study was whether or not the physician analysis included those who had previously faced a meritless lawsuit – and wanted to avoid such a painful process by ordering test upon test to reduce any future risk..

“Future research should explore what specific tests and procedures doctors overuse mainly for defensive purposes and the effect this practice has not only on medical errors and adverse events but also on over-diagnosis and escalating costs,” the analysis concludes.

Leading to more questions than it answers, the study is an important conversation starter on the escalating costs of defensive medicine and the work that must be done at the federal level to rein in spending, keep health care accessible, and put an end to medical lawsuit abuse.

To read more about the defensive medicine study of Florida physicians, click here.

An Uncertain Future for Women’s Access to Care

Continuing with the trend found in previous surveys, the 2015 Association of Obstetricians and Gynecologists Survey on Professional Liability again gave health policy makers pause as physicians detailed the impact that a harsh medical liability climate has on their practice – and patients.

Out of the more than 4,000 ACOG fellows and junior fellows surveyed, half indicated that between 2012 and 2014 they made changes to their practices as a result of the risk or fear of medical liability claims or litigation. For nearly 24 percent of respondents, that meant no longer accepting high-risk obstetric patients, and in the case of five percent of respondents – stopping the delivery of babies altogether.

Respondents indicated that, on average, they stopped practicing obstetrics at age 48 – the age at which many physicians consider themselves at the prime of their careers.

It’s clear through a review of claim data that medical liability issues are a real reason driving the changes, with nearly three-quarters of the physicians reporting that they were faced with one or more lawsuits. For those who elaborated on the outcome, half of the lawsuits were dropped, dismissed, or settled without any payment to the plaintiff – leaving physicians to foot the bill for their defense and their time away from patients.

“In sum, the current medical-legal environment continues to deprive women of all ages, especially pregnant women, of their most educated and experienced women’s health care physicians,” the ACOG survey concludes.

“Quality health care for women is negatively affected through a diminution of obstetric services, a reduction in gynecologic surgery, and the widespread practice of defensive medicine.”

To read the ACOG survey results in full, click here.

Medical Liability Costs Felt by Family Budgets

With consumers across the country feeling the ill effects of cost of living increases, a new analysis identifies the lack of medical liability reform as a costly policy misstep that adds to the expenses of the average American family.

Identifying 12 costly policy mistakes and missteps, the Heritage Foundation details the costs borne by all of us, due to inaction by state and federal governments.

Specifically noting that medical liability reform could be immediately addressed at the state level, the analysis of our broken system indicates that “potentially devastating awards increase the use of unnecessary procedures.”

Recent estimates by the CBO have shown that liability reform at the federal level would save upwards of $50 billion over 10 years, giving American families, on average, a savings of $82 each year from initial action at the state level. The savings would work its way through the health care system, likely appearing in the form of lower health care costs and taxes.

Improvements to state laws, as was done in Texas and California, have left patients in those states with access to the care they need at a price they can afford. Elsewhere, patients are left picking up the tab.

To read more about how the lack of medical liability reform leads to higher expenses for all Americans, click here.