Here's an excerpt from his piece in the 10/28/2011 "Weekly Update" for the Medical Society for the State of New York:
I'm Dr. Art Fougner and I'm a recovering obstetrician.(Read the full text for additional discussion by Dr. Fougner of the costs of defensive medicine.)
Defensive medicine consists of office visits, lab tests, imaging studies, and procedures that have less to do with patient care and more to do with chart care. Defensive medicine measures are primarily used not to ensure patient health, but to safeguard against a potential medical malpractice suit.
Defensive medicine is pervasive. In the September 2011 issue of the Archives of Internal Medicine, Sirovich, et al noted that 83% of primary care physicians admit to defensive practices and concluded, "the extent to which fear of malpractice leads to more aggressive practice (so-called defensive medicine) has been hotly debated; based on our findings, we believe it is not a small effect.”
In the ACOG 2009 survey, more than two-thirds of the OB/Gyns made changes to their practice because of liability concerns— 11% of OBs stopped delivering babies; 1.5% retired. In 2009, seven New York Counties did not have a board-certified obstetrician.
In a 2005 survey, Studdert found that 93% of physicians practice defensive medicine.
I submit that number is a low-ball estimate...
As a radiologist, I see this every day. ER physicians, primary care doctors, and specialists order many imaging tests that they don't want to (and don't feel are medically necessary) because of the fear of malpractice lawsuits if they don't order a test and the patient turns out to have a rare-but-dangerous condition.
Given the current medico-legal climate, that's an entirely rational response by these doctors. Why should they risk their careers in order to save the hospital (or the 3rd party payors) a few dollars if they'll risk legal penalties for doing so?
Genuine free-market health care reform (as opposed to ObamaCare) will have to include rational tort reform as part of the solution.
