Defensive medicine, never good for you

Picture yourself entering your doctor’s office with some mundane ailment. The doctor checks you over and comes up with a diagnosis that only requires simple remedies. But despite the doctor’s conviction that the diagnosis is correct, he or she orders a barrage of tests just to check that everything else is normal. Several tests and more bills down the line, you are back to square one.

Nothing else is the matter, and the initial diagnosis and proposed remedies remain unchanged.

This is defensive medicine at its best. Most of the tests were completely unnecessary, but were done simply to protect the doctor from a potential lawsuit in the event that something was missed! Ridiculous? Yes, but defensive medicine is now commonplace in medical practice. A recent physician survey reported that 75% of doctors order more tests, procedures and prescriptions that they deem likely unnecessary in attempts to avoid lawsuits.

Some economic estimates report that one in four dollars spent in healthcare can be attributed to defensive medicine alone. That’s billions of dollars annually, passing the cost along to everyone and significantly driving up the cost of healthcare. And with hardly any added benefits to patients.

So why does it happen? We are living in a pretty litigious age, where professionals face real fears of ending up in court at some point in their careers. Physicians will practice defensive medicine based on perceived risks of being sued, both for errors of commission or omission. Patients too are increasingly looking for potential medical loopholes, with readily available support from compensation-based legal entities.

Are there ways you can help yourself and escape from defensive medicine? You can in some ways. You need to be self-aware of your ailments, and have some idea of what is medically necessary, and what isn’t. Ask your doctor why a disproportionate number of tests are being ordered. Why is a seemingly avoidable procedure being proposed? Aim for a balanced discussion with the doctor as well, gathering as much information as possible to help you make decisions. Don’t be overly suspicious, majority of doctors are well-meaning and are not out there to deliberately cause harm, their business is to get you better.

Doctors have a role to play as well. They need to concentrate on practicing medicine without a morbid fear of being sued. There is no place to recommend unnecessary tests and procedures, especially when the diagnosis is clear. Medical errors can never be completely eliminated. But processes can easily be put in place to minimize the chance of errors to negligible limits. Defensive medicine, and a medical environment driven by litigation are hardly the ideals of healthcare delivery.

In extremes defensive medicine borders on malpractice, which itself is open to litigation. Best way is to avoid it altogether, and uphold the age-old ideals of the Hippocratic Oath.