Of the $2.5 trillion dollars spent each year on healthcare, doctors say that 10 percent of this amount is attributable to practicing defensive medicine and paying for malpractice insurance, while lawyers attribute less than .5 percent of this spending on payments for medical malpractice settlement costs.  Around 720 doctors who responded to a 2008 survey by the Massachusetts Medical Society reported practicing defensive medicine in fear of facing a malpractice lawsuit, estimating the cost of extra tests to be around $281 million and unnecessary hospital admissions around $1.1 billion.  A study by researchers at the Harvard School of Public Health and Columbia Law School performed in 2005 found 93 percent of the 824 doctors who participated reported practicing defensive medicine. Lawyers attribute the rising costs of healthcare to “bad medicine,” insisting that medical malpractice suits protect patients from the devastating effects of medical errors. Lawyers also feel that the extra tests involved in the so-called practice of defensive medicine are really fueled by the self-interest of the doctor, arguing that many doctors have a financial interest in laboratories that conduct extra tests or procedures creating a conflict of interest which could add to the level of unnecessary tests.

Congress is currently deciding how to curb the rising costs of healthcare. A 2009 Congressional Budget Office analysis estimates that government health care programs could save $41 billion over 10 years if national limits on jury awards for pain and suffering in malpractice suits were enacted, along with similar restraints.  Along with this approach, there has also been a drive for less adversarial approaches to limiting rising malpractice costs. The University of Michigan Health System uses a system in which doctors acknowledge mistakes and then offer compensation, causing malpractice claims to fall from 121 in 2001 to 61 in 2006.  Another movement, which has found less support with lawyers, is a campaign enacted in part by the Sorry Works! Coalition urging doctors to apologize for their wrongdoing and provide prompt compensation when appropriate.

Commentary: In the article, Dr. James Wang points out that he makes an effort to tell his patients when the treatments they may be considering are not necessary in order to keep the cost of providing care to a minimum. If the patients insist that they have the unnecessary test done though, Wang admits to ordering or performing the procedure in order to protect himself from a medical malpractice lawsuit later. Wang is among many doctors who admittedly perform defensive medicine in order to protect themselves from suits of medical malpractice. The catch here is that in many cases, doctors are not practicing “bad medicine” and are actually attempting to inform patients that the treatments they seek are not required for their health. In these, the majority of situations, if the choice comes down to protecting themselves from a lawsuit even though they practiced sound medical judgment or ordering tests even though they incur further unnecessary costs, how can society fault doctors for choosing to protect themselves?

msnbc.com, Nov. 4, 2009.