High Levels of Malpractice Concern Linked to Practice of Defensive Medicine

August 14, 2013 | Strategic Insights for Health System


Office-based physicians who possess a high level of malpractice concern are more likely to engage in practices that would be considered defensive medicine when diagnosing new patients, according to the results of a study published in the August 2013 issue of Health Affairs. The study linked physicians’ responses regarding their levels of malpractice concern as reported in the 2008 Health Tracking Physician Survey to Medicare Parts A and B claims for the patients they treated during the study period who visited their offices with new complaints of chest pain, headache, or lower back pain. The data indicated that when compared with physicians with lower levels of malpractice concern, physicians with higher levels were more likely to refer their patients with chest pain to the emergency department (ED), order advanced imaging studies for their patients with a headache, and order conventional and advanced imaging studies for their patients with lower back pain. In addition, when compared with less-concerned physicians, more-concerned physicians were less likely to use stress testing for patients with chest pain and more likely to refer them to the ED, where a more extensive workup and observation would likely be performed.

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