What is Defensive Medicine?

Alex Tree

Defensive medicine refers to both diagnostic and therapeutic measures that are taken primarily to prevent being sued for negligence. In defensive medicine, additional tests, drugs, and therapies may be recommended solely, or at least primarily, to reduce the doctor’s chance of successfully being sued for malpractice. The doctor might also attempt to avoid potential malpractice lawsuits altogether by refusing to treat certain patients. Health professionals in some countries, such as the United States, nearly always practice defensive medicine due to the relatively high risk of medical malpractice lawsuits.

Defensive medicine helps prevent doctors and hospitals from being sued due to medical negligence.
Defensive medicine helps prevent doctors and hospitals from being sued due to medical negligence.

Several types of defensive medicine are practiced around the world. One type is called avoidance behavior, meaning that the health professional avoids the problem completely. Those who exhibit avoidance behavior tend to turn away current patients when performing a high-risk procedure. They may also refuse to take on new patients with illnesses that usually require high-risk procedures. Avoidance behavior is less common than the second type of defensive medicine.

Assurance behavior, the second type, is when a doctor orders tests and other services that are not entirely necessary to diagnose or treat the patient. By doing this, the doctor can reduce the chance of making a mistake and document evidence that he or she treated the patient to the best of his or her ability. These tests and services can be costly to the patient and health insurance companies in addition to being entirely or mostly unnecessary.

Defensive medicine is a highly debated topic, particularly how much money is spent on it and how it affects patients. Researchers can only estimate the total amount of money spent on extra testing and services, and those estimates vary wildly from one to another. At least one study shows that the practice is not in the patients’ best interest and it normally decreases the quality of care. Unnecessary tests and procedures can put the patient at risk in addition to delaying the most effective treatment and sometimes requiring the patient to pay more out of pocket.

Contrary to popular belief, defensive medicine is not solely a problem in the United States. The United Kingdom, Italy, and Japan also have doctors who request unnecessary procedures to limit their liability. This list of affected countries goes on, but some countries worry much less about this type of medicine due to laws that protect doctors. For example, French laws make it very difficult to sue a health professional in France. Even so, the United States is one of the top countries affected by doctors who practice defensive medicine.

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