Medicare patients undergo more diagnostic tests and emergency department referrals when they are treated by physicians who fear malpractice lawsuits, according to a new study from the Center for Health System Change.
The study found that physicians' perception of risk, rather than actual risk, of malpractice liability was linked to their use of defensive medicine. The study also suggests that traditional malpractice reforms, like capped damages, do not change physicians' defensive medicine habits.
Patients with chest pain were more likely to be referred to the ED if their physician had a high or medium level of malpractice concern, according to the study. Patients with a headache were more likely to receive advanced brain imaging, such as a CT or MRI scan, if their physicians had high levels of malpractice concern.
Researchers compared physicians' level of malpractice concern with objective state-level indicators of malpractice liability risk, such as whether a state capped economic damages, but found no consistent relationships, according to the study.
"Traditional malpractice liability reforms don't appear to resolve the concerns that drive physicians to practice defensive medicine," Emily R. Carrier, MD, an HSC senior researcher and study co-author, said in the release. "Dealing with defensive medicine, which not only increases costs but subjects patients to unnecessary care, may require reassuring physicians that medical injuries can be resolved in less adversarial and stressful ways while still protecting patients."
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