The Massachusetts Medical Society has published a report suggesting that doctors in Massachusetts are ordering thousands of tests as a result of “defensive medicine.” As a result, the Society argues, health care costs in Massachusetts are increasing unnecessarily. The Society also argues that in order to trim these rising costs, medical malpractice reforms are necessary.
These claims have, of course, been made before. For over twenty years doctors have been claiming that malpractice claims have driven them to excessive testing. However, independent analysis in 2004 at the Congressional Budget Office found the evidence that defensive medicine was contributing to soaring insurance costs to be “weak and inconclusive.” And, as Marc Breakstone, a member of the firm of Boston medical malpractice firm of Breakstone, White & Gluck, PC, pointed out in the Boston Globe today, managed care and utilization review reduce medically unnecessary tests.
Ronald Gluck, another member of the Massachusetts malpractice firm, Breakstone, White & Gluck, P.C., explained to the National Law Journal that there were serious questions about the survey data. He also pointed out that many tests must be approved by insurance companies, which help reduce unnecessary testing.
There are, of course, other sides to this story. Physicians who order more tests may be increasing their own revenues by billing for the tests. And hopefully, the extra testing has some benefit for patients, who can be reassured when conditions are actually ruled out.
The claims of the Medical Society are quite stark. They report that 83% of the doctors they surveyed reported practicing some level of defensive medicine. The report also indicates 18-28% of tests and procedures, and 13% of hospitalizations were ordered to avoid lawsuits.