“Mr. X, you’ve been diagnosed with…” These words are spoken in hospitals around the country every day and each time they are spoken, a line is drawn between doctor and patient. On one side is the doctor wondering if enough has been done to defend against being sued for malpractice. On the other side is the patient with a need for someone to blame for his or her condition and seeing the doctor as the sole reason for any injured state. This division between doctor and patient has led to a practice called defensive medicine and it has also created a healthcare system riddled with inefficiency and in need of an overhaul. There is talk of healthcare reform and how it is important to control costs to the patient through lower health insurance premiums and limits on how much a hospital should charge for services. What is not heard is how it is important to control the costs doctors face through malpractice insurance premiums and the costs associated with being sued by a patient after a less-than-full recovery. Defensive medicine has a negative impact on the overall cost of healthcare delivery and changes in tort laws placing limits on malpractice awards should be part of the reform conversation. An analysis of changes in statutory limits on lawsuits and prior tort reform efforts will show a connection between such changes and a reduction in overall healthcare costs.
Defensive Medicine as defined in a presentation to the World Health Organization, means “when a doctor orders a test, prescribes a drug, or even schedules a surgery, not because it is necessary, but to avoid being sued if the patient fails to make a full recovery (Dietrich, 2005, pg. 28).” This use, or overuse, of medical procedures to avoid litigation is a common practice in many industrialized nations. The percentage of procedures considered to be defensive is typically larger in countries with easy-to-navigate legal systems, and even higher in countries that do not have many burdens on the party filing the legal action. The United States legal system exists with many favorable conditions for filing malpractice lawsuits, including low burden of proof requirements, lax limits on damage awards, and the lack of a cost-sharing provision on filing a legal action.
Impact of Defensive Medicine
The same World Health Organization presentation details the cost of medical litigation rising from $3 billion per year to $24 billion per year between 1975 and 2002 (Dietrich, 2005, pg. 27). The amounts awarded in medical lawsuits have an impact on healthcare delivery in the form of increased insurance costs to the consumer and doctor, or a reduction in services to help cover the cost of litigation. A survey conducted by the Massachusetts Medical Society (MMS) asked 900 physicians if they had practiced defensive medicine procedures. Eighty-three percent of the doctors reported that they had ordered defensive procedures an average of 18 to 28 percent of the time. They also...