Docs admit malpractice fears lead to overly aggressive care
Doctors admit to being part of the healthcare problem, fessing up that they provide too much medical care in a nationwide survey published in the Archives of Internal Medicine. They said malpractice concerns, current reimbursement structure, and quality measurement systems drove them to practice more aggressive healthcare.
Almost half (42 percent) of the 627 surveyed physicians said their patients "were receiving too much medical care" and another 28 percent said they had ordered more tests and made more referrals to specialists than they would like, reports the Los Angeles Times.
The doctors said fear of malpractice lawsuits (76 percent) and clinical performance measures (52 percent) were the most common drivers of their more aggressive practices. Another 40 percent don't spend enough time with their patients to figure out what's wrong, so they ordered tests and consultations to provide answers.
Eighty-three percent of the physicians said they could be sued if they didn't order a test that was indicated, whereas only 21 percent said they could be sued for ordering a test that wasn't indicated, according to the Wall Street Journal. The incentives, therefore, point toward "when in doubt, do more," says Brenda Sirovich, an author of the study and a staff physician and research associate in the Outcomes Group at the VA Medical Center in White River Junction, Vt.
The study also found that 40 percent of doctors thought other primary care physicians were driven by extra income that results from ordering more tests, although only 3 percent said financial considerations influenced their own practice style, Reuters reports.
"I'm not saying that physicians do tests in order to make money--there is a potential to be a real cynic here--but I think that the reimbursement model for most healthcare encourages utilization in a variety of ways," Sirovich said. "It's a time for us to reflect about what incentives we have built into our healthcare system, and what directions they are taking us in," she added.
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