Defensive Medicine

As far as wasteful spending in the healthcare system, defensive medicine accounts for a staggering sum at an estimated $210 billion per year. To make matters worse, according to a 2005 survey conducted by the Journal of the American Medical Association, over 90% of participating physicians admitted to practicing defensive medicine. Why would such a large fraction of physicians engage in something which has been deemed “wasteful?”

First of all, what is defensive medicine? Imagine you’re a physician attending to a patient who presents with a headache. Rather than prescribing Tylenol and bed rest, you order expensive (and potentially unnecessary) imaging tests, blood panels, etc. to cover all the bases. Why? You’re worried that as this patient’s doctor, you risk a lawsuit in the event that you fail to properly diagnose their problem.

As a future physician, I can vaguely see the pros and cons of this practice. Doctors are too worried about getting sued, so they order all sorts of tests to make the diagnosis as accurate as possible at the expense of the patient; however, patients are concerned with saving money.

So I ask my readership – how do we go about resolving the aforementioned conflict of interest?

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  1. we all have problems don’t we?

    1. ask the patient; give options and consequences (some can be stubborn though)
    2. have a set, basic standard/procedure that’s effective- like meeting in the middle (i’m sure they have this already, but make it better?)
    3. change the legal system pertaining to healthcare (haha; stop sueing doctors- and bad doctors need to stop practicing, i.e malpractice- what a wish).

  2. inform the patient of the likelihood of a more serious alternative to something simple like just a stress headache? leave it up to them?

    patients these days show up to health care facilities with printouts and pamphlets thinking they have brain tumors and all kinds of strange diseases if they have one of 45 symptoms, wanting all kinds of tests or drugs

    (i’ve had people show up to the pharmacy with pamphlets wanting discounted drugs that they dont have prescriptions for, telling me they have the symptoms. i’m like alright, neat. where’s the prescription? they don’t have one… they think they can just tell me and i can give it to them.. ay ay ay)

    so, these days people are quite opinionated and (ummm kind of) informed. if you give them the option, maybe they’ll decide what they want 🙂

    • The general consensus regarding how to resolve this dilemma is precisely what you said – making patients aware of all the alternatives. Haha, there’s no need to be politically correct. We both know that people who think they’re more informed than pharmacists/doctors/dentists/etc. in their respective trades never really are. 😀 But see, I can be at peace with myself knowing that if I asked for a prescription drug from Pharm-Dee-Kay-See (that’s your new ghetto pharm name) not only would you grant it… but you’d give me some sort of crazy, under-the-table discount. It’s great to have friends in high places. 😉

      PS to anyone else reading – Don’t worry, it’s all a joke. I don’t actually plan on single-handedly destroying our healthcare system. I’ll leave that to our newly elected president. 😀 *Hides*

      • Ah, typical AMA fear-mongering (they said the same about Medicare and Medicaid in 1965). I do think that it is interesting that Republican politicians have not actually put out any alternatives, just slogans like “free-market, competition based healthcare”, thinking that people are stupid enough (well most are), to not realize that this is what we have now. So then the public has no choice but to side with Democrats who do present an option even if it’s not the greatest by far (same for other issues : education, environment, etc.). You do know that private insurance companies are really the ones destroying our healthcare system right? New technological innovations, new drugs, etc. are created, in spite of private insurance companies (who are unwilling to pay for them), not bc of them. Some reform is necessary which both sides agree on. Not to mention, I thought conservatives liked competition in the market place, so why are conservatives against a public plan giving competition to private plans?

  3. I think the main reason as you stated is that doctor are afraid of getting sued. I think they are using the better safe than sorry method and who can’t blame them. People nowadays are suing doctor for ridiculous reason that is why the cost of health care gone up. I see this way as two side of the knife. The pro side can be you can detect a disease early and it easier to treat. Certain disease such as pancreatic cancer can guarantee longer life span if detected at an early stage and it also good since people rarely go to the doctor and once they do it is only for one thing to get treated. This could be bad since plenty of disease could occur asymptomatic and are death ridden.

    The con side of this is that doctor are doing all this test and all this test will caused both doctor and patients plenty of money. it take plenty of money for doctors to run them and it cost plenty of money for patient to paid for them. This test could also take up lab time of scientists, they could spent that time treating on more serve cases. This take money out of the government and government could spend those money on better research.

    I don’t know Rishi. They are both good side and bad side. I think that the decision you have to make my friend when you are a doctor. My best advice is to go with your pass experience and instinct. If you feel Mr. x may have a disease y run all the test, if not let him go free.


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