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 here.

Without liability reform, Ob/gyn shortage is on the horizon

Major metropolitan areas face an access to care crisis that will hit women hardest, as Ob/gyn doctors face challenges that force them to retire early or accept fewer patients.

SELF Magazine reported that a survey of 30,000 practicing Ob/gyns (which factored age and workload) found that cities such as Las Vegas, Los Angeles, and Miami could see a substantial drop in the number of practicing Ob/gyns.

Similarly, the American College of Obstetricians and Gynecologists projected the shortage at nearly 9,000 physicians by 2030, and over 15,000 by 2050, according to their recent report on gynecologist workforce issues.

An Ob/gyn’s exposure to medical liability lawsuits, and the high cost of liability insurance needed to defend against them, is a key factor in driving potential medical students away from the specialty. As a result, women will be left with fewer options for prenatal and delivery care.

To read more about how women’s access to care could be threatened without changes to our health care system, click here.

Patient safety efforts, liability projects detailed in latest AHRQ report

While traditional comprehensive liability reforms remain pending in Congress, demonstration projects have taken place at health care organizations and hospitals across the country to test new approaches and fixes to our broken medical liability system.

Recently released by the Agency for Healthcare Research and Quality (ARHQ), a new report compiles commentary and studies of a series of planning and demonstration projects funded in 2010 as alternatives to traditional solutions to address both patient safety and medical liability issues.

Individual reports and studies covered projects that touched on two of the three goals of the demonstrations – preventing harm through best practices, and improving communications with patients.

“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,” prefaced the report’s authors.

The report also noted several challenges involved in studying newer ways to address patient safety and liability concerns, including “the common fear that engaging patients in dialogue around harm, safety, or even fallibility will create increased legal activity from patients.”

To read the full AHRQ report’s insights regarding the demonstration projects, as well as future areas of exploration in patient safety and medical liability issues, click here.