What the Doctors in the “Defensive Medicine” Study are Really Saying

The debate over "defensive medicine" is back in the headlines with the release of a recent survey. Researchers claim that 91 percent of physicians practice “defensive medicine.” On the surface you might think, “Wow, really? 91 percent?” However, let's take a look at what this number portrays.

The survey by Mount Sinai School of Medicine in New York asked doctors their opinions about the following statements:

• “Doctors order more tests and procedures than patients need to protect themselves against malpractice suits,” and
• “Unnecessary use of diagnostic tests will not decrease without protections for physicians against unwarranted malpractice suits.”

The Physicians’ Views on Defensive Medicine: A National Survey was published in the June 28th issue of the Archives of Internal Medicine.  To me, the findings are worthless.  These doctors were simply answering a question. Any doctor who says that he or she orders unnecessary tests is ultimately admitting to insurance fraud. 

You can’t validate a case for “defensive medicine” solely on some doctors’ opinions. Show me the medical records that back up this 91 percent figure that is being promoted. I want proof that these tests and procedures weren’t justified by the medical conditions.

According to Tara Bishop, MD, associate, Division of General Internal Medicine at Mount Sinai School of Medicine, and coauthor of the study, “the study shows that an overwhelming majority of physicians support tort reform to decrease malpractice lawsuits and that unnecessary testing, a contributor to rising healthcare costs, will not decrease without it.” 

That’s not what this study is telling me.  There is a problem, but it doesn’t have to do with medical malpractice claims.  It has to do with the healthcare industry. Doctors are working harder and getting paid less, because insurers are under reimbursing physicians. Will tort reform fix that issue?