Spending more on patients lowers malpractice risk, study finds


Physicians who spend more money and resources conducting tests and procedures for patients are less likely to be sued for malpractice, according to a new study that indicates defensive medicine may work.

Published Wednesday, November 4, 2015, by BMJ, the study by researchers at USC, Harvard University and Stanford University noted that doctors in surveys worldwide said they practice defensive medicine - doing more for patients because they believe it reduces liability risk.

The study affirms this widely-held assumption, tying higher spending to lower malpractice claim rates through an analysis of Florida physician and claims data.

Researchers also gave special attention to Caesarean deliveries due to ongoing concerns that many C-sections are performed predominantly due to physicians' malpractice concerns. The link was obvious here, too: the more C-sections that an obstetrician performed, the less likely he or she was to face malpractice complaints.

The findings raise concerns that malpractice risk could be an impediment to health care reform.

"More and more we are relying on physicians to help eliminate wasteful spending in health care. However, if physicians perceive that lowering spending will subject them to greater malpractice risk, it will be that much harder to move the needle on health care spending," said Seth Seabury, an author on the study from the USC Schaeffer Center for Health Policy and Economics.

Legislators and federal officials have tried to remove financial incentives for physicians and hospitals to provide excessive treatment through payment reform.

"One of the reasons we are moving away from the fee-for-service model is to remove the incentives of physicians to spend more. But if spending continues to shield physicians from liability risk then that incentive will still be there," said Seabury, who also is an associate professor of research at the USC School of Pharmacy and at the Keck School of Medicine of USC's Department of Emergency Medicine.

A doctor's effort can influence the outcome of a malpractice lawsuit.

"Higher spending may signal to patients, judges and juries that despite an error, the doctor did everything possible to help," said Dr Anupam Jena, the study's lead author who is a Harvard Medical School associate professor in the department of health care policy.

BMJ, USC, Harvard University, Stanford University, US, Malpractice