October 31, 2013

162017_132140396847214_292624_nOne of the most noisy cries for medical malpractice tort reform in the United States is that medical providers engage in so-called defensive medicine in states where medical malpractice tort reform has not been enacted because they fear that if they do not practice defensive medicine, they will be subject to claims of malpractice if their patients suffer unanticipated harms. When health care professionals talk about defensive medicine, they are generally referring to the belief that doctors and other medical providers order tests and medical treatment that they would not otherwise order solely because they fear that they may be sued for medical malpractice if they failed to order such tests or provide such treatment.

It is enlightening that patients do not complain that their medical providers engaged in what the providers may consider to be defensive medicine — patients want and expect the best medical care available to them and if their medical testing comes back “negative,” they typically do not complain that they had the test. No patient facing a potentially serious medical condition objects that they received more medical testing than what the applicable standard of care may have required — most people believe in the old adage, “better safe (by ordering a medical test) than sorry (where the results of a test not ordered would have changed the medical treatment and resulted in a better outcome for the patient).”

In a recently published study in the Journal of Patient Safety entitled, “The Relationship Between Tort Reform and Medical Utilization,” the researchers hypothesized that if the hidden costs of defensive medicine is a significant driving force in the increase of health-care costs in the United States, then it would be expected that those states with higher levels of tort reform will have a decrease in Medicare utilization and that medical utilization will decrease after tort reform is enacted.

The researchers analyzed state-level reimbursement data for 1999 to 2010 and medical malpractice tort rankings for all 50 U.S. states, and correlated the data with state medical utilization for 2010. They found that data was available to compare pre-tort reform and post-tort reform in Mississippi, Nevada, and Texas. They concluded that medical expenditures in those three states both before and after their respective passage of comprehensive medical malpractice tort reform “gave inconsistent results and did not demonstrate substantial or meaningful total Medicare savings. In Mississippi, there was a trend of decreased expenditures after medical tort reform was passed. However, in Texas, where 80% of the analyzed enrollees resided, there was a trend of progressive increasing expenditures after tort reform was passed.”

The study concluded that “defensive medicine is [not] a driver of rising health-care costs. Additionally, comparing Medicare reimbursements, premedical and postmedical tort reform, we found no consistent effect on health-care expenditures. Together, these data indicate that medical tort reform seems to have little to no effect on overall Medicare cost savings.”


Next time someone tells you that doctors practice defensive medicine that leads to the increase in health care costs for all of us, ask them for the proof and refer them to this study.

If you may be the victim of medical malpractice in the United States, you should promptly contact a local medical malpractice attorney in your state who may investigate your medical malpractice claim for you and represent you in a medical malpractice lawsuit, if appropriate.

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