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A Study of Defensive Medicine

As the conversation around healthcare revolves heavily upon reining in costs, a new study out of the National Bureau of Economic Research has been able to focus on how “defensive medicine” contributes to the costs.

Jonathan Gruber, health economist at MIT, and Michael D. Frakes, a Duke University economist and lawyer, found a segment of the population, active-duty members of the military and their families, to offer what is perhaps the most precise estimate yet of how much defensive medicine matters, at least for care in the hospital.

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Their study “Defensive Medicine: Evidence From Military Immunity” highlights that physicians, when faced with the possibility of being sued, did increase the amount of healthcare patients received by up to five percent — but that such extra care did not necessarily result in better outcomes.

While active duty military patients are barred from suing for medical malpractice, care to their family members are not so immunized. Drawing from that variation, the authors found “suggestive evidence that liability immunity reduces inpatient spending by five percent with no measurable negative effect on patient outcomes.”

Advocates of reforms to the country’s medical liability system say that the threat of litigation forces physicians to order unnecessary tests and procedures to protect themselves in a lawsuit. Here in California, the Medical Injury Compensation Reform Act (MICRA) limits awards for noneconomic damages in medical professional liability lawsuits to promote patient access to medical care. Lisa Maas, executive director of Californians Allied for Patient Protection, said of the new study: “The benefits of medical liability reform laws like California’s existing MICRA stabilize medical liability costs and, encouraged by the results of this study, it is another example of how strong liability reforms empower physicians to minimize the use of defensive medicine.”

Link to study: http://www.nber.org/papers/w24846

 

Gabriela Villanueva is CAP’s Public Affairs Analyst. Questions or comments related to this article should be directed to gvillanueva@CAPphysicians.com.