Many emergency department physicians over-order costly advanced imaging tests for fear of missing unlikely, but possible, conditions and being sued for malpractice, according to a study published in the journal Academic Emergency Medicine.
To determined the prevalence of over-ordering in the ED, researchers surveyed 435 emergency physicians and trainees on their advanced diagnostic imaging ordering practices for CT scans and MRIs.
Highlighted below are five findings from the survey:
- More than 85 percent of respondents reported too many diagnostic tests are ordered in their own EDs.
- Ninety-seven percent said at least some of the advanced imaging studies they personally order are medically unnecessary.
- Fear of missing a low-probability diagnosis and fear of litigation were the main perceived contributors to over-ordering tests.
- Nearly 80 percent of respondents said malpractice reform would be "extremely" or "very" helpful for reducing unnecessary imaging.
- Other solutions suggested to help cut down on unnecessary imaging included increased patient involvement through education (70 percent), shared decision-making (56 percent), feedback to physicians on test-ordering metrics (55 percent) and improved education of physicians on diagnostic testing (50 percent).