Defensive medicine is widely practiced and may lead to increased costs, lower quality of care and less access to services, a study of Pennsylvania physicians indicated. Researchers surveyed 824 Pennsylvania physicians in the specialties most frequently involved in litigation: emergency medicine, general surgery, neurosurgery, obstetrics and gynecology, orthopedic surgery and radiology. Ninety-three percent of the doctors reported sometimes or often engaging in defensive medicine, according to a report on the survey in the Journal of the American Medical Association. Practices meant to protect against oversight, such as performing extra diagnostic tests or referring patients for consult, were about twice as common as avoidance practices, such as refusing to perform certain procedures or treat certain patients. More than 59% of respondents said they often ordered more tests than medically indicated (70% among emergency physicians.) Some 32% of respondents said they had limited their practice or avoided procedures as a defensive step. Physicians said they ordered extra tests not only out of legal concerns but also to pacify demanding patients, feel more confident in their decisions and create a paper trail indicating they had tested patients for particular conditions. Read the abstract. -- by Andis Robeznieks
Defensive medicine nearly universal in high-risk fields
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