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Health and medicine

Study: Doctors' legal fears lead to epidemic of 'defensive medicine'

CHICAGO - Fear of being sued leads an alarming number of doctors to practice "defensive medicine," such as ordering unnecessary tests and avoiding risky procedures, a survey found.

The practice has been around for decades and is no secret to many patients. But the survey of 824 Pennsylvania doctors suggests it is surprisingly common, researchers said.

A separate study found caps on malpractice damages and other changes in liability law appear to have less effect on the nation's supply of doctors than supporters of tort reform contend.

The studies were published in today's Journal of the American Medical Association.

Ninety-three percent of the Pennsylvania doctors surveyed in 2003 said they sometimes or often practiced "defensive medicine" due to legal concerns.

That means they engaged in unsound practices that exposed patients to potential harm, said Dr. Peter Budetti, a public health professor at the University of Oklahoma Health Sciences Center. "Perhaps the greatest irony is that defensive medicine may be counterproductive and actually might increase malpractice risk," said Budetti, who wrote an accompanying editorial.

Examples include performing breast biopsies in women with lumps unlikely to be cancer, hospitalizing low-risk patients with chest pain and eliminating high-risk procedures or abandoning medicine altogether.

The other study found that the supply of doctors increased throughout the nation from 1985 to 2001, even in states with no malpractice reform laws. Government data show there were 497,140 professionally active doctors, excluding osteopaths, in 1985, and 709,168 in 2001.

Compared with no-reform states, the supply increased about 3 percent more in states with reforms such as malpractice award caps, the analysis found.

Both studies were funded by the Pew Charitable Trusts.

[Last modified June 1, 2005, 00:39:12]