Susan L. Davis RN, EdD
St. Vincent's Health services Bridgeport, CT
The breakdown: The problem of defensive medicine is very real, and I am honestly surprised that only 58% of physician leaders said they had practiced defensive medicine in the past year.
The drivers: There is so much information out there now for healthcare consumers on the Internet, and more often than not they come to physicians with a test that they believe they need to have done given the symptoms they have. It is a very real concern for physicians because while they may not believe the test is appropriate or needed, they feel compelled to order it because of the chance that they may be wrong. It may be only a 1% or 2% chance that they are wrong, but they are exposing themselves to litigation.
The solutions: The tough part is what do you do about it? Many would say that there is a tremendous need for malpractice reform. That is important, but that is not the only thing we need to do to address this issue. When you look at it on a broader scope, there are two things that come to mind: One is practicing evidence-based medicine and having the relationship with the patient that enables the physician to explain why that test is not needed or appropriate for the symptoms the patient has presented. The second solution comes with information technology: connecting all of the providers for that patient on the continuum of care so physicians see what has been done for the patient either at a hospital or by another provider. When those results are available, the physician is able to explain to the patient what the results of the test were and why duplicative testing is not necessary and in fact not good for them.
This article appears in the April 2012 issue of HealthLeaders magazine.