Defensive medicine — performing additional test and procedures out of concerns over possible malpractice lawsuits instead of expected benefits to the patient — occurs at especially high rates in states with high-risk liability environments, according to a survey by Timothy R. Smith, MD, and colleagues from Northwestern University.
According to the survey, more than 80 percent of the 1,026 neurosurgeons surveyed said they had ordered imaging tests, more than three-fourths reported ordering laboratory tests and making extra referrals and nearly half said they ordered more medications and procedures, each solely for defensive reasons.
The survey found all of these defensive behaviors occurred at higher rates in high-risk states. Neurosurgeons in high-risk states were 30 percent more likely to order additional imaging studies and 40 percent more likely to order additional laboratory tests out of fear of being sued.
Nearly half of neurosurgeons in high-risk states reported they stopped performing high-risk procedures, nearly one-fourth stopped performing brain surgery and almost 40 percent considered retirement because of liability concerns, the survey found.
According to overall survey results, rates of defensive medicine reflect an accurate perception of actual liability risk by state.
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