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Doctors Agree Malpractice Fears Drive Overuse of Tests

Almost all surveyed physicians say more tests and procedures are ordered than needed

MONDAY, June 28 (HealthDay News) -- A large majority of physicians agree that the practice of defensive medicine -- stemming from malpractice concerns -- is responsible for an overuse of medical tests and procedures, according to a research letter in the June 28 issue of the Archives of Internal Medicine.

Tara F. Bishop, M.D., of the Mount Sinai School of Medicine in New York City, and colleagues surveyed 2,416 physicians, including primary care physicians, non-surgical (medical) specialists, surgical specialists, and other specialists. The survey asked the physicians to rate their agreement with two statements: "Doctors order more tests and procedures than patients need to protect themselves against malpractice suits" and "Unnecessary use of diagnostic tests will not decrease without protections for physicians against unwarranted malpractice suits."

The researchers found that, overall, 91 percent of the 1,231 respondents agreed more tests and procedures are ordered than needed out of fear of malpractice suits, including 91.2 percent of generalists, 88.6 percent of medical specialists, 92.5 percent of surgeons, and 93.8 percent of other specialists (P = .35). A large majority also agreed that protections against unjustified malpractice suits are needed to reduce the unnecessary use of diagnostic tests (90.7 percent).

"Our findings indicate that physicians want protection from liability risk. Further, they suggest that proposals to promote cost-effective care, such as the promulgation of guidelines from a national comparative effectiveness center, could be limited by physicians' fears of malpractice unless such protections are ensured. Malpractice reform should focus on ways of offering assurance to physicians that they will have protection against malpractice if they competently practice the standard of care," the authors write.

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