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Harvard study: Fear of malpractice lawsuits is driving defensive medicine

Fear of malpractice lawsuits is the immeasurable driver behind defensive medicine, according to a Harvard University researchers study published in a recent edition of Health Affairs. This touches on an interesting facet of medical malpractice suits and defensive medicine. The report indicates that focusing reform efforts on money alone, with tort reform and damage cap efforts, may not do enough to reduce the costs associated with defensive medicine.

The report estimates that $45.6 billion was spent on defensive medicine in 2008. A total of 2.4% of the total healthcare spending in the U.S. was attributable to the “medical liability system”. And while this is a staggering sum, it does not quantify one of the leading drivers of these costs. That is fear.

One Washington-based consultancy theorized that a physician’s fear of being sued for $50,000 is just as great as being sued for $500,000. At the core of this fear seems to be concerns for a physicians reputation, self-confidence, belief in his or her ability to help patients and a loss of trust. All of these may be greater forces behind defensive medicine than previously thought. This concept appears to fly in the face of efforts to place damage caps on non-economic damages as the best way to limit defensive medicine. In fact, the report seems to suggest that caps may not be in the best interest of patients.

At its essence, the report seems to suggest that the so-called “medical malpractice crisis” may be much harder to address than previously thought. Transparency, disclosure information, non-economic cap tort reforms (such as eliminating joint and several liability, venue shopping, etc.) and other reform ideas may be more effective than the popular call for damage caps.

The injection of fear as a driving force behind an issue that has been largely discussed in purely economic and measurable terms raises a new set of questions and may well call for a new set of long-term solutions that have so far been ignored.

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