Lawsuit fears contribute to overtesting in the ED

Fear of litigation appears to be driving emergency department physicians to order unnecessary tests for patients, but the very nature of the ED itself may also be a factor.

All physicians worry about missing something, but the stakes are even higher in the ED, and that can lead to unnecessary tests and scans, the Associated Press reports. In particular, many emergency physicians say that fear of malpractice suits is the main reason behind their efforts. "It has everything to do with it," Dr. Angela Gardner, president of the American College of Emergency Physicians, told the AP

ED physicians are among the most likely to be sued for malpractice; the Physicians Insurers Association of America, which represents almost two-thirds of private practice doctors, lists more than 600 lawsuits against such doctors between 2006 and 2008. Currently, there are an estimated 116 million ED visits annually, and research suggests the number is only going to continue to rise.

The nature of the ED is also a factor in the high rate of testing. "I do think tests are ordered more frequently because you're dealing with a little bit of an information vacuum," said Dr. Joel Wacker, of the Madison (Wisc.) Emergency Physicians tells the Wisconsin Daily Journal. ER doctors usually deal with patients they've never seen, he explains. He says testing in emergency rooms is driven less by the fear of lawsuits than concern with proper diagnosis and treatment.

To learn more:
- read this Associated Press article via USA Today
- check out this piece in the Wisconsin State Journal