The Myth of Defensive Medicine

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Some have argued that doctors practice so-called defensive medicine in order to avoid medical malpractice claims. Defensive medicine, in this context, may be understood as ordering tests and exams that are precautionary but perhaps not really necessary. These same people will argue that defensive medicine causes health costs to soar and are a direct result of doctors’ concerns about being sued for medical malpractice. Yet, the federal government’s own research shows quite a different fact pattern. According to a detailed study by the American Association for Justice, “While proponents of tort reform argue that defensive medicine drives up the cost of health care, government researchers question whether defensive medicine truly exists. The Congressional Budget Office has called the evidence of defensive medicine “not conclusive,” and summarized, ‘On the basis of existing studies and its own research, CBO believes that savings from reducing defensive medicine would be very small.’ Researchers at Dartmouth College echoed these conclusions, saying, ‘The fact that we see very little evidence of widespread physician exodus or dramatic increases in the use of defensive medicine in response to increases in statemalpractice premiums places the more dire predictions of malpractice alarmists in doubt.’

The Government Accountability Office (GAO) has issued similar statements questioning the occurrence of defensive medicine, saying, ‘the overall prevalence and costs of [defensive medicine] have not been reliably measured,’ and study results cannot be generalized to estimate the extent and cost of defensive medicine practices across the health care system. The GAO reported that even “officials from AMA [American Medical Association] and several medical, hospital, and nursing home associations…told us that defensive medicine exists to some degree, but that it is difficult to measure.” The truth is that defensive medicine has a negligible effect on healthcare costs and its existence is not causally related to medical malpractice claims.

Mark Abramson
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