Many physicians believe patients' inappropriate demands or requests for medical tests or treatments are partially responsible for ballooning healthcare costs, but the rate at which these requests are satisfied is actually very low, according to a recent study published in JAMA Oncology, of which Ezekiel Emanuel, MD, PhD, was the senior author.
Additionally, physicians feel compelled to do additional tests and procedures to protect themselves from medical malpractice suits. Despite their beliefs, the study shows malpractice and defensive medicine account for a very small portion of rising healthcare costs.
The study analyzed 5,050 patient-clinician encounters involving 3,624 patients and 60 clinicians in three oncology outpatient facilities between October 2013 and June 2014.
Here are five key takeaways from the study:
- Among the 5,050 encounters, 440 (8.7 percent) included a patient demand or request for a medical intervention, according to the study.
- Clinicians complied with 83 percent, or 365, of the clinically appropriate demands.
- Only in 11.4 percent of the encounters (50 encounters) did the patient demand or request clinically inappropriate interventions.
- Clinicians complied with seven (14 percent) of these inappropriate demands or requests. They complied with inappropriate demands or requests in only 0.14 percent of the 5,050 total encounters.
- Nearly half — 49.1 percent — of patient demands were for imaging studies, 15.5 percent were for palliative treatments (excluding chemotherapy and radiation), and 13.6 percent were for laboratory tests.