Although the total cost of defensive medicine in the United States remains difficult to pin down, a recent study suggests that orthopedic surgeons are responsible for about $2 billion of the annual tab.
The study, published in the February American Journal of Orthopedics and presented at the annual American Academy of Orthopedic Surgeons meeting in San Francisco, cross-referenced survey responses of 1,214 orthopedic surgeons with Medicare payment information from the 2011 Current Procedural Terminology code reimbursement data.
According to the study, 96 percent of respondents admitted they ordered tests, specialist referrals or hospital admissions in an effort to limit their malpractice liability. Imaging tests were particularly susceptible to the trend with nearly a quarter of the scans ordered for purely defensive reasons. Respondents also said that defensive medicine drove 35 percent of specialist referrals, 23 percent of laboratory tests, 18 percent of biopsies and 7 percent of hospital admissions.
Individually, orthopedic surgeons spent an average of $8,484 each month and $101,820 per year on the practice of defensive medicine, accounting for almost one fourth of their total practice costs, noted researchers Manish K. Sethi, codirector of the Vanderbilt Orthopaedic Institute Center for Health Policy, and colleagues.
The study results show that physicians "are clearly concerned about malpractice issues, and they're adjusting their practice procedures based on that fear," Sethi stated in a CMIO article. Study authors pointed to better coordination with radiologists and other physicians, as well as increased use of computerized physician order entry and decision support, as potential solutions to curb defensive medicine and bring down costs.