Defensive Medicine

Malpractice

Liability, Legal

Insurance, Liability

Israel

Defensive medicine

Manny Sethi

Mark McClellan

Non-economic damages caps

Overscreening

Caesarean delivery on maternal request

Expenditures in the United States federal budget

Operant conditioning

Health care reforms proposed during the Obama administration

Health care quality

Comparison of the healthcare systems in Canada and the United States

Jim White (defensive end)

Medical malpractice in the United States

Health court

Yujin Nagasawa

Jim Talent

Ezekiel Emanuel

Supplier-induced demand

Choosing Wisely

Chop block (gridiron football)

Hycleus phaleratus

Choosing Wisely Canada

Emilio S. Liwanag

Personal injury lawyer

Tort reform

National Football League Defensive Player of the Year Award

Quaternary prevention

Deficit reduction in the United States

Unnecessary health care

Cerebral palsy

Cost of defensive medicine5

• Estimates of the extent and cost of defensive medicine vary widely. (medicaleconomics.com)
• This article noted that the estimated cost of defensive medicine in the US for the specialty of orthopedic surgery alone is 2 billion dollars annually. (medchrome.com)
• Using the average national Medicare payment information from the 2011 Current Procedural Terminology (CPT) code reimbursement data, the cost of defensive medicine per orthopaedic surgeon respondent was approximately $8,500 per month or $100,000 per year, representing 24 percent of a physician's annual spending. (theamericanchiropractor.com)
• Given the U.S. Department of Labor's statistic of 20,400 practicing orthopaedic surgeons in the U.S., investigators estimate the national, annual cost of defensive medicine for the specialty of orthopaedic surgery at $173 million per month or $2 billion each year. (theamericanchiropractor.com)
• Those tests and treatments also cost money … some health economists suggest the cost of defensive medicine now exceeds $100 billion a year. (heartland.org)

Malpractice14

• Defensive medicine is a reaction to the rising costs of malpractice insurance premiums and patients' biases on suing for missed or delayed diagnosis or treatment but not for being overdiagnosed. (wikipedia.org)
• In doctors who had faced a malpractice lawsuit in the past five years, the level of defensive testing rose markedly. (insurancespecialists.com)
• When asked if they practice defensive medicine and are concerned or feel pressure by the threat of a malpractice suit, the study found that there was little difference in the level of concern among physicians practicing in the high-risk states and those in the lower-risk states. (mediate.com)
• A survey by Mount Sinai School of Medicine researchers has found that 91 percent of physicians believe concerns over malpractice lawsuits result in "defensive medicine," ordering more tests and procedures than necessary as a protective measure. (mountsinai.org)
• About $60 billion is spent annually on defensive medicine and many physicians feel they are vulnerable to malpractice lawsuits even when they practice competently within the standard of care," said Tara Bishop, MD, Associate, General Internal Medicine at Mount Sinai School of Medicine, and co-author of the study. (mountsinai.org)
• So often it kills me to see an analysis of the cost of malpractice to medicine as the sum of the cost of the insurance and the cost of judgements against physicians and out of court settlements. (medicaljustice.com)
• Study of Medical Students' Malpractice Fear and Defensive Medicine: A "Hidden Curriculum? (escholarship.org)
• Finally, a minority of students worried about practicing and learning procedures because of MC (16.7% [95% CI=10.7% to 25.1%]).Conclusion: Although third- year medical students have little concern about being sued, they are exposed to malpractice concerns and taught considerable defensive medicine from faculty. (escholarship.org)
• However, less than a quarter of students felt their specialty choice would be influenced by malpractice worries and that malpractice concerns lessened their enjoyment of learning medicine. (escholarship.org)
• In an editorial in the JAMA, Budetti writes, "Perhaps the greatest irony is that defensive medicine may be counterproductive and actually might increase malpractice risk. (medchrome.com)
• Defensive medicine is what happens when doctors order too many tests because they are afraid of missing a diagnosis and later losing a multi-million dollar lawsuit for malpractice. (blogspot.com)
• I think the astronomical increase in malpractice costs for physicians is well known, but I do have a concept of defensive medicine practices. (rushlimbaugh.com)
• Kim, EK, Fletcher, WJ & Johnson, CT 2019, ' Effect of Increasing Malpractice Insurance Cost and Subsequent Practice of Defensive Medicine on Out-of-Hospital Birth Rates in the United States ', American journal of perinatology , vol. 36, no. 7, pp. 723-729. (johnshopkins.edu)
• The structure of malpractice protections under the Military Health System (MHS) provides a novel opportunity to understand how the presence of malpractice pressure leads to "defensive medicine. (nber.org)

Practice defensive medicine2

• Pulling out the responses from Texas, Jackson reported that 80% of Lone Star State doctors said they still practice defensive medicine with 64% reporting no change in their behavior since caps went in effect in 2003, 31% reporting a decrease in defensive medicine practices and 5% reporting an increase. (mediate.com)
• Unfortunately, the current legal climate forces good doctors to order these tests and practice defensive medicine," said Douglas W. Lundy, MD, FACS, chair of the AAOS Medical Liability Committee. (theamericanchiropractor.com)

Physicians15

• Tort law in many countries and jurisdictions not only discourages but actively penalizes physicians who practice evidence-based medicine. (wikipedia.org)
• A recent article in US News and World Report , Most U.S. Physicians Practicing Defensive Medicine, claims that physicians are ordering more tests and escalating the work-up of sick patients, all in the name of defensive medicine. (kevinmd.com)
• Furthermore, it alienates patients even further from their physicians - and this, perhaps, is the greatest cause of increased lawsuits and patient dissatisfaction, which starts the cycle of practicing defensive medicine all over again. (kevinmd.com)
• The results of a groundbreaking study by the Children's Hospital of Philadelphia revealed that a major portion of the tests performed by doctors fall under the category of defensive medicine, prescribed by physicians to protect themselves from potential lawsuits rather than out of medical necessity. (insurancespecialists.com)
• In an online survey of more than 3,000 physicians conducted last December by Jackson Healthcare, an Alpharetta, Ga.-based staffing and hospital management company, 92% of respondents said they practiced some form of defensive medicine. (mediate.com)
• The study, which questioned 2,416 physicians, is published in the June 28 edition of Archives of Internal Medicine. (mountsinai.org)
• This should come as no surprise, given that physicians, consultants, and academics who study the practice of medicine don't always agree on how to define the term. (medicaleconomics.com)
• Using a liability-effectiveness model, Pauker and Pauker have shown that "when physicians attempt to avoid liability by practicing defensive medicine, some patients will experience decrements in expected health, but no patients experience increments in expected health," while Dekay and Asch note that defensive testing reduces the overall quality of patient care. (medchrome.com)
• Physicians who specialize in one particular area of medicine will often complete well over 10 years of study in order to complete college, medical school, a residency program, and fellowship program before practicing in their chosen specialty. (robertedenslawoffice.com)
• One study showed that out of over 1,000 board certified physicians, more than 80% admitted to ordering more imaging tests for defensive reasons. (robertedenslawoffice.com)
• By comparing patients whose physicians are not subject to "defensive medicine" pressure to other comparable patients (perhaps even treated by the same physician) whose physicians are subject to such pressure, we can identify the impact of defensive medicine pressure on practice patterns, medical costs, and patient outcomes. (nber.org)
• Leading integrative physicians (such as Sidney Baker, M.D., speaking at a recent Institute of Functional Medicine symposium) point out the wisdom of "listening to your patient" And using clinical experience not just machines to diagnose. (anh-usa.org)
• The increase would be much higher, however, if estimates distinguished between specialists and family doctors, as the majority of US physicians crossing the border are in family medicine, said Philpott. (cmaj.ca)
• Doctors are seeing more payments from value-based care contracts, but fee-for-service medicine that pays physicians based on volume is still dominant, new data shows. (naylornetwork.com)
• In addition, private practice, defensive due to the controversy on the optimum CS rate in 2015 medicine, financial incentives and convenience induce and emphasized that a rate greater than 10% had no bene- physicians to perform more CSs ( 9 ). (who.int)

Practices5

• Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, over 400 outpatient practices, nearly 300 labs, a school of nursing, and a leading school of medicine and graduate education. (mountsinai.org)
• There are billing practices and different drug names to be learned, and American doctors often feel the need to order more tests - a practice known as defensive medicine - to avoid lawsuits, she said. (cmaj.ca)
• Deliveries are complicated," said hospital obstetrician Dr. William Hamilton, admitting he practices "defensive medicine. (theweek.com)
• such practices are referred to as defensive medicine. (msdmanuals.com)
• 4. Employers should establish a Safe Driving program which includes communicating distracted driving principles/restrictions and reviewing defensive driving practices with all vehicle drivers. (cdc.gov)

Behavior2

• Defensive medicine takes two main forms: assurance behavior and avoidance behavior. (wikipedia.org)
• Extending this analysis to certain additional measures, however, I do find some evidence consistent with positive defensive behavior among obstetricians. (duke.edu)

Lawsuits4

• Introduction: Defensive medicine is a medical practice in which health care providers' primary intent is to avoid criticism and lawsuits, rather than providing for patients' medical needs. (escholarship.org)
• Most students believe that fear of lawsuits will decrease their future enjoyment of medicine. (escholarship.org)
• Unfortunately for many patients, this 'defensive medicine' is becoming more and more common as doctors shy away from providing the care that they believe is right for their patient and move toward providing the care they believe will protect them from lawsuits. (robertedenslawoffice.com)
• These are tests or studies that are taken not to improve diagnostic accuracy, but essentially to practice CYA medicine for liability from lawsuits. (rushlimbaugh.com)

Unnecessary tests1

• Even though most sued doctors are found innocent, 93 percent of all doctors admit practicing defensive medicine - ordering unnecessary tests, referrals and procedures - to protect themselves from the threat of a lawsuit. (pacificresearch.org)

Obstetricians2

• In a study with 824 US surgeons, obstetricians, and other specialists at high risk of litigation, 93% reported practicing defensive medicine, such as ordering unnecessary CT scans, biopsies, and MRIs, and prescribing more antibiotics than medically indicated. (wikipedia.org)
• AIM: To evaluate the perception of 'Defensive Medicine' by hospital obstetricians and the influence of this attitude on the choice of cesarean delivery. (uniba.it)

Biopsies1

• Participating orthopaedic surgeons also acknowledged that defensive medicine was the motivation behind 35 percent of specialist referrals, 23 percent of laboratory tests and 18 percent of biopsies. (theamericanchiropractor.com)

Cesarean2

• Defensive medicine' in the choice of cesarean section]. (uniba.it)
• Outcome measures were experience and confidence in training for operative vaginal and breech delivery, use of the partogram in labour, opinion about a trial of labour after a previous cesarean section and about section on request, personal perception of Defensive Medicine. (uniba.it)

Ricin1

• Griffiths GD, Understanding ricin from a defensive viewpoint. (cdc.gov)

Conclusions1

• CONCLUSIONS: Defensive Medicine is a reality that encompasses all categories of doctor in this survey. (uniba.it)

Tort Reform1

• CALLER: No, I think tort reform would limit this, the practice of defensive medicine. (rushlimbaugh.com)

Reform2

• In December 2010, the American Academy of Orthopedic Surgeons cited estimates that, by reducing defensive medicine, liability reform could result in yearly savings from $54 billion to $650 billion. (medicaleconomics.com)
• LUNDBERG: And there's still to be seen what medical liability reform would actually make that change, because defensive medicine becomes part of a culture of medicine. (medpagetoday.com)

Specialty1

• Defensive medicine drives up the cost of patient care and limits patient access to specialty care, neither of which are in the interest of our patients who deserve the best and least costly care possible. (theamericanchiropractor.com)

Doctors4

• The practice of defensive medicine also expresses itself in discrepancies between what treatments doctors recommend to patients, and what they recommend to their own families. (wikipedia.org)
• Doctors and patients might be able to see the human face of medicine if the traditional practice style that valued provider-patient relationship came back into use. (ican-online.org)
• Dr. Kevin Pho runs the popular medical blog, Kevin M.D., where doctors routinely confess exactly how they run up costs by practicing defensive medicine. (blogspot.com)
• Doctors have a term for it: "defensive medicine. (zocalopublicsquare.org)

Medical liability2

• Modern Physician recently reported about a study by Harvard researchers that says the nation's "medical liability system" accounted for approximately "$55.6 billion-or 2.4% of total healthcare spending in 2008-with almost $45.6 billion of that figure being spent on the practice of "defensive of medicine," which includes ordering tests and procedures or avoiding high-risk patients in an effort to avoid being sued. (mediate.com)
• Medical liability systems have been accused of increasing health expenditure insofar as they induce the practice of defensive medicine. (repec.org)

Patient6

• Defensive medicine, also called defensive medical decision making, refers to the practice of recommending a diagnostic test or medical treatment that is not necessarily the best option for the patient, but mainly serves to protect the physician against the patient as potential plaintiff. (wikipedia.org)
• Rather than realizing this, clinicians have begun to practice test-centered medicine rather than patient-centered medicine. (kevinmd.com)
• He poignantly recalled his experience as a family medicine resident, when he was sued for letting a patient decide whether to be screened for prostate cancer after engaging him in shared decision making, as current guidelines recommend. (annfammed.org)
• The role of practice guidelines and evidence-based medicine in perioperative patient safety. (ahrq.gov)
• This practice of defensive medicine, while useful in a courtroom, does little or nothing to enhance patient outcomes. (heartland.org)
• This is not just a good defensive medicine practice, but also a practice that will promote the health of the patient overall. (medscape.com)

Medico-legal1

• According to research from Penn State University, over 90% of what is practiced in allopathic medicine is defensive medicine -that is, treatment that is not necessary except for medico-legal purposes and medical regulatory reasons. (anh-usa.org)

Litigation1

• According to a broad survey of emergency medicine professionals, fear of missing a low-probability diagnosis and fear of litigation are perceived as two key contributing factors. (rand.org)

Largely2

• Closer to the trenches, Edmund Funai, MD, professor of obstetrics/gynecology at Ohio State University in Columbus, Ohio, and chief operating officer of the OSU Health System, thinks defensive medicine exacts a huge, largely unmeasured financial cost. (medicaleconomics.com)
• This phenomenon of defensive medicine may largely be born out a very human response to the expectation of perfection we have in society today, especially with care providers. (ican-online.org)

Patients8

• Theoretical arguments based on utilitarianism conclude that defensive medicine is, on average, harmful to patients. (wikipedia.org)
• Ironically, by practicing defensive medicine we are not practicing quality medicine - and isn't that what patients really want? (kevinmd.com)
• The study indicates that states including Texas, California and more than a dozen others who have placed limits on noneconomic damages may "not be best for patients" and may not provide the solution to curbing defensive medicine. (mediate.com)
• GPs consider defensive actions to be carried out as a result of succumbing to various sources of pressure deriving from the system, the patients, the GPs themselves and peers. (bmj.com)
• SAN FRANCISCO, Feb. 9, 2012 /PRNewswire-USNewswire/ - In a first-ever national survey of orthopaedic surgeons, 96 percent said they have practiced defensive medicine - the ordering of tests, referrals to specialists and hospital admissions primarily to avoid liability and without significant benefit to patients - according to a new study presented today at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS). (theamericanchiropractor.com)
• And the costs of defensive medicine today are increasingly paid by patients, even those with insurance - because of rising deductibles and co-payments. (blogspot.com)
• They don't go into medicine to make money, they go into it because of what they're passionate about and taking care of patients. (medpagetoday.com)
• I did not go into medicine to make judgments on patients' behaviors. (medscape.com)

Physician1

• Prior to ever practicing medicine, the defensive attitude comes with the education a physician receives in medical school and the training in residency. (ican-online.org)

Intensive2

• In 2004, the case of Dr. Daniel Merenstein triggered an intensive debate in scientific journals and media on defensive medicine (e.g. (wikipedia.org)
• In the US, they practise fairly intensive defensive medicine, and in Canada we don't encourage that. (cmaj.ca)

Emergency Medicine1

• Working in partnership, emergency medicine and primary care can address rural populations' most pressing social and medical needs. (rand.org)

Costs4

• Defensive medical decision making has spread to many areas of clinical medicine and is seen as a major factor in the increase in health care costs, estimated at tens of billions of dollars annually in the US. (wikipedia.org)
• In May 2011, for example, the Web site DefensiveMedicine.org cited surveys by healthcare staffing company Jackson Healthcare and the Gallup polling organization indicating that defensive medicine costs the United States $650 billion to $850 billion annually. (medicaleconomics.com)
• Eliminating defensive medicine is "an easy thing we can do to lower costs. (theamericanchiropractor.com)
• And this costs about 15% of all medicine costs, or $360 billion a year. (rushlimbaugh.com)

Estimates2

• Although estimates for how much is spent on defensive medicine vary widely, experts agree that the dolllar amount is large. (medicaleconomics.com)
• The study estimates the annual cost of defensive orthopaedic care at $2 billion. (theamericanchiropractor.com)

Reasons2

• In India, a rise of physical attacks on practitioners and lack of support from public and government systems are the prime reasons for defensive medicine. (wikipedia.org)
• More specifically, 24 percent of tests were ordered for defensive reasons: 19 percent of radiography tests, 26 percent of CT scans, 31 percent of MR images and 44 percent of ultrasounds. (theamericanchiropractor.com)

Estimate1

• Defensive medicine these days is so pervasive, some estimate its yearly cost at more than $100 billion. (blogspot.com)

Influence1

• Influence of defensive hostility in cardiovascular functioning. (bvsalud.org)

Care4

• Defensive decision making does not only occur in health care but also in business and politics. (wikipedia.org)
• By making care and thus insurance more expensive, defensive medicine has added 3.4 million Americans to the rolls of the uninsured. (pacificresearch.org)
• How is defensive medicine understood and experienced in a primary care setting? (bmj.com)
• Before defensive medicine and doctor shortages change the health care system that serves this country and its people so well. (prnewswire.com)

Specialists1

• Specialists are professionals who specialize in one or a few areas, rather than practice in general medicine and their fees can vary depending on the nature of the illness or injury. (robertedenslawoffice.com)

Threat1

• Confronting the threat of bioterrorism: realities, challenges, and defensive strategies. (cdc.gov)

Study1

• The purpose of this study was to characterize medical students' exposure to defensive medicine during medical school rotations. (escholarship.org)

Opinion1

• Well it's my opinion this is defensive medicine," Varipapa said. (blogspot.com)

Hospital3

• The Mount Sinai Medical Center encompasses both The Mount Sinai Hospital and Mount Sinai School of Medicine. (mountsinai.org)
• Established in 1968, Mount Sinai School of Medicine is one of few medical schools embedded in a hospital in the United States. (mountsinai.org)
• Defensive hospital admissions averaged 7 percent each month. (theamericanchiropractor.com)

Culture2

• Blame culture and defensive medicine. (ahrq.gov)
• And Zalzala appreciates the lack of a "defensive medicine" culture. (cmaj.ca)

Researchers1

• In September 2010, researchers asked 2,000 orthopaedic surgeons to complete a Web-based survey on defensive medicine. (theamericanchiropractor.com)

Percent1

• Of the total tests administered, 20 percent could be termed "defensive. (insurancespecialists.com)

Increase1

• Objectives Recent years have witnessed a progressive increase in defensive medicine (DM) in several Western welfare countries. (bmj.com)

Large1

• For instance, managers of large international companies report making defensive decisions in one third to half of all cases, on average. (wikipedia.org)

Procedures1

• About 93% of them reported that they were practicing defensive medicine, with excessive investigations and procedures. (medchrome.com)

General1

• Employing a qualitative methodology eliciting discussion and reflection among general practitioners (GPs), we have been able to achieve a nuanced understanding of defensive medicine (DM) that is closely connected to the everyday experiences, routines, activities and views of GPs in relation to DM. (bmj.com)