Malpractice Fear Factor

Lancet Staff Report

Citing a report in Health Affairs (September, 2010), Joe Cantelupe points out several interesting pieces of information as to the effect of fear of malpractice litigation on doctors. Many doctors report that they are forced to practice defensive medicine, which contributes to unnecessary procedures and a rise in the cost of healthcare. Over $55 billion dollars are spent each year for malpractice liability and defensive procedures.

Cantelupe provides details of a conversation he had with James Reschovsky, senior health researcher of the Center for Study in Health System Change. A study revealed that the fear of litigation caused physicians to over-test for conditions that actually had a lower risk for a negative medical outcome.

Some may think that a move toward tort reform may have an impact on reducing the fear factor of litigation on physicians. This apparently is not the case. Reschovsky reports that, even in states where tort reform has occurred, the behavior of physicians with regard to malpractice fear has not diminished. Even when the risk quotient is relatively low, physicians’ concerns of medical malpractice are inordinately high. The types of reforms reported include caps on litigation damages. Even so, OBYGN’s and emergency physicians are especially fearful of malpractice claims.

Unfortunately, defensive medicine is often thought to be the best defense against litigation. Cantelupe reports that the estimated cost of defensive medicine, out of the fear of malpractice litigation,reaches over $45 billion per year. He also suggests that the cost of fear is not only monetary, but is also affecting the way in which physicians interact with their patients. Communication between physician and patient may diminish causing doctors to no longer perform their jobs in the manner they choose.

As the United States moves toward health reform, the entire issue of fear from litigation plays a major role in the overall goals of that reform.

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