Consumer group goes on offense about defensive medicine

Arguments to limit medical liability judgments in an effort to curb defensive medicine practices that inflate the cost of healthcare are based on biased surveys and not solid evidence, according to a report from the Public Citizen consumer advocacy group.

The report, "Defensive Medicine: The Doctored Crisis" (PDF) concludes that "reliable empirical evidence paints a vastly different picture” from that of recent studies that calculated that defensive medicine adds $45.6 billion or more to the country's healthcare bill.

Defensive medicine is defined as avoiding high-risk patients or ordering medical tests or procedures in an effort to avoid being sued. Public Citizen argued that unnecessary tests are more likely to be done for financial gain than for defensive purposes. It added that caps on malpractice judgments have not been shown to lower healthcare costs.

The report also concluded that "unreliable surveys have provided fodder for most of the alarmist claims on defensive medicine," and said that these surveys are unreliable because of bias in self-reporting, leading questions and a "failure to distinguish between merited and wasteful 'defensive' practices."

The report says the way to lower defensive medicine costs is for doctors to follow medical society-developed guidelines for ordering diagnostic tests and for Medicare reimbursement formula reform that would limit the profitability of owning high-technology diagnostic equipment.