The thought of malpractice for many doctors begins as soon as a patient walks into the door. The subsequent fear and actions that follow are known as defensive medicine. Defensive medicine, “occurs when doctors order tests, procedures, visits, or avoid high-risk patients or procedures, primarily (but not necessarily or solely) to reduce their exposure to malpractice liability.”
Defensive medicine can benefit patients. Concerned about malpractice liability, doctors encourage patients to attain more testing and second opinions even if the expected benefits are minimal. These efforts decrease the risk of negligence while allowing patients to feel secure in their doctor’s opinion. Therefore, defensive medicine can prove beneficial.
On the other hand, defensive medicine is problematic for patients and physicians. Malpractice is the most challenging issue for physicians and the cost to fight them continues to rise. However patients face a different problem, access to medical treatment or certain specialists becomes difficult. They are subject to exorbitant costs because of the amount of secondary exams necessary before a high-risk procedure is provided. As a result, there is an unnecessary amount of health care spending because doctors fear being sued for malpractice. In 2010, defensive medicine accounted for 45.6 billion out of the total 2.3 trillion national health care cost.
However, the cost of defensive medicine was not always this high. Some researchers and doctors have been able to connect cesarean sections to defensive medicine. Cesarean sections increased from 4.5 percent in 1965 to 30 percent in 2010. Today, obstetricians are more likely to pose cesarean sections to patients at the first sight of a complication. Therefore, the prevalence of cesarean sections is a good indicator of the increase of defensive medicine over the years. In lieu of lawsuits resulting from the increase in defensive medicine, how are doctors supposed to practice medicine with the fear of being sued for negligence?
The American Medical Association (AMA) has proposed a solution called safe harbor. This proposal would prevent doctors from being sued for failing to order a test, if the doctor followed guidelines that indicate a test was unnecessary. This idea provides benefits to both the doctor and the patient. The patient is protected because there is an established standard of care that the doctor must uphold or face liability. Also, doctors are protected because they are given the opportunity to be doctors and make the best decision for their patients while using a readily applicable standard.
Studies have shown that defining medical malpractice liability by a nationwide regime would reduce local variation in care and provide a national standard that doctors could easily follow. In states that have chosen to adopt the AMA safe harbor proposal, the amount of medical malpractice has decreased by 30 to 50 percent in conjunction to the rest of the nation. By decreasing the incentive to follow local customary practices, which are less likely to be supported by clinical evidence, decreased variations in clinical care that commonly leads to malpractice and defensive medicine.
In sum, although defensive medicine has increased there are solutions. The advocates at the AMA have proposed one that has changed the amount of medical malpractice suits in states through providing a nationwide standard for doctors supported by clinical evidence. I believe this decrease will lead to more doctors being able to practice without the fear of lawsuits and decrease defensive medicine.