The Cost of Defensive Medicine

In an article I originally found in Medical Economics, Dr. Jeffrey Segal does a wonderful job explaining how defensive medicine drives up the cost of healthcare.  Segal, a neurosurgeon, is CEO of Medical Justice and a board member of Patients for Fair Compensation, a non-profit seeking to revamp the medical tort system.  His points are summarized below but read the article:

  • Eighty-two percent of doctors order more tests and procedures than are medically necessary — and almost on a daily basis — in fear of potential lawsuits.
  • About one in four dollars spent in healthcare can be attributed to these tests and procedures that are clinically unnecessary.
  • Unnecessary tests and procedures are estimated to cost about $650 billion a year.
  •  Up to $125 million a year is paid by Medicare for unnecessary tests and procedures and up to $96 billion is paid by Medicaid for unneeded tests and procedures.

He summarizes by saying that:

Doctors often feel compelled to order these tests or treatments because patients demand it. In today’s world, patients expect quick remedies for their symptoms. When they don’t get immediate relief, they push physicians to use the latest technologies to discover what’s wrong. It’s the American way. As long as a doctor feels he could be the potential target of a frivolous lawsuit, he will keep ordering the tests and procedures. The only substantive solution is to revamp our nation’s medical tort system so physicians don’t feel the need to double-check their diagnosis with expensive testing.

Right on, my brother.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  3 comments for “The Cost of Defensive Medicine

  1. Janine
    June 16, 2012 at 3:54 pm

    Sure! Let’s save the insurance companies money so their executives can make 105 million instead of 100 million per year! We don’t want to order pesky ‘unnecessary’ ‘defensive’ medicine tests on those bothersome patients with those ‘complaints’. They’re all just faking anyway. If only they would just give the money to the insurance companies and stop going to doctors and asking for medical care, then everything would be peachy keen.

  2. Kathy
    June 13, 2012 at 3:40 pm

    I am a “recovering” lawyer, but found myself wondering why in our profession we don’t hear about “defensive law.” I suspect it’s because our clients pay directly for services. If a client says “I want you to do this unnecessary thing,” I would say “Great, but you are going to pay me XXX for me to do it.” I think the separation of payment from demand is at least as much at fault for this phenomenon as liability claims. It takes that difficult conversation and establishment of common goals out of the equation.

  3. Pat
    June 8, 2012 at 2:32 pm

    Doug I just flat don’t believe the statistic of 82%. It think that figure is artificially low, probably due to physicians being dishonest, or rationalizing their decisions, rather than admitting that they too help drive up costs out of fearfulness. Count me in the CYA majority.

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