You Can’t Pretend Defensive Medicine Doesn’t Exist
A survey of 202 fourth-year medical students and third-year residents at Northwestern University Feinberg School of Medicine in Chicago found that 94% of students and 96% of residents have seen examples of defensive medicine in their clinical training. Somehow this comes as a surprise to American Medical News reporter but the bottom line is that we can’t pretend it doesn’t exist. The medical “lottery system” is a reality and without tort reform (not tort removal) then nothing will change and our students will perpetuate this costly ritual. Truly sad.
When I was in training every time someone could not explain why a test was being done the reason given was defensive medicine. I’ve subsequently learned that the reasons, at least outside of academia and in primary care, are far more complex, and if not for profit then usually related to not thinking things through or not wanting to take the time to explain what should be done. If we cared that much about avoiding lawsuits we would pay attention to the experts when they tell us what suits are likely and what leads to them, like giving patients the impression you don’t care.
I teach students “If it’s bony and it hurts, x-ray it. It’s the patient’s ankle, but it’s your ass…”
I’ll stop practicing defensive medicine when I stop fearing patients and their families…which will never happen.
Only 94 and 96 percent? Weren’t the others paying attention?
I would argue that it will take a generation to change defensive medicine as MRI’s for sprains and 42 item lab panels on healthy 30 year-olds have become a habit that non one questions or considers. If M4’s think this is “normal” they will teach it as normal for the next several decades.