Is “Defensive Medicine” Really Reducing Malpractice Lawsuits?

There have been several articles about “defensive medicine” and its effect on malpractice suits in the news since the British Medical Journal (BMJ) released the results of a study on November 4.

The study was conducted by researchers at the University of Southern California, Harvard Medical School and Stanford University. The intent of the study was to investigate the claim that “defensive medicine” may reduce potential claims of medical malpractice.

First, what exactly is, “defensive medicine”?

Defensive medicine is defined as “…medical care provided to patients solely to reduce the threat of malpractice liability rather than to further diagnosis or treatment.”

The study showed that across seven medical specialties, a higher average spending was associated with a lower risk of malpractice claim.  Another position cited in the study states, “…failures in physician-patient communication make up for a substantial fraction of malpractice claims”.

Some argue “defensive medicine” is “careful medicine”. If a test doesn’t result in a seemingly needed diagnosis, shouldn’t testing continue until one is found? A large percentage of “defensive medicine” is practiced in emergency rooms, where a doctor may have no history whatsoever with a patient, and no records to go by. Here, it may be hard to distinguish between defensive medicine and careful medicine.

At Mitchell, Hoffman and Wolf, we find that in most of the new cases brought to us, the primary issue is that the doctor or hospital has not communicated effectively or sufficiently to the patient or the patient’s family. People are looking for answers and an understanding in clear terms about what happened and what comes next. Having not received a sufficient answer from their doctor, they turn to a lawyer handling malpractice cases.

The University of Michigan Health System implemented a communication and resolution program for its outpatients and inpatients in 2001. Malpractice claims dropped by 36% through 2007, while attorney and patient compensation costs dropped by 59%.

Whether “defensive” or “careful”, the Michigan Model has proven that better communication has reduced malpractice claims. While there is no easy solution to “defensive medicine” or the various positions around it, something we should all agree on is that patients deserve clear communication around their testing and diagnosis. If the result of improved doctor-patient relationships is a reduction in medical malpractice, we all win.