September 3rd, 2009

Reports the Wall Street Journal:

When a patient shows up at a doctor’s office with a bruise after falling and bumping his head, the physician might order a CT scan even if she believes the injury is superficial.

Worries about a malpractice lawsuit might prompt her to take steps that aren’t medically necessary. “If I don’t get a CAT scan, this is that one case where I’ll end up in court,” the doctor might think, says Cecil Wilson, a physician who is president-elect of the American Medical Association.

This is defensive medicine — a careful, fretful approach to treating patients, in which doctors authorize tests in part to reduce the risk that they will be sued. In the national debate over health care, doctors and policy makers often point to spending on defensive medicine as a key driver of soaring costs.

Calculating how much defensive medicine actually costs is extremely difficult, because medical professionals often have many motivations for ordering tests and other procedures. The U.S. spends a higher percentage of its gross domestic product on health care than any other nation in the industrialized world. Legal expenses contribute to the bill.

Even so, health-care experts say the direct costs of medical malpractice — the insurance premiums, claims paid and legal fees — amount to a very small portion of overall health-care spending.

Total spending on medical malpractice, including legal-defense costs and claims payments, was $30.41 billion in 2007, according to an estimate from consulting firm Towers Perrin. That is a significant figure, but it still amounts to a little more than 1% of total U.S. health-care spending, which the federal government estimates at $2.241 trillion for 2007.

Indirect costs that stem in part from medical professionals looking for legal protection play a far larger role in health-care spending, doctors and some analysts say. And they are one reason medical liability is bubbling as an issue as Congress reviews whether to pass a health-care overhaul. Sen. John Kerry, a Democrat, and Sen. Orrin Hatch, a Republican, both said earlier this week that Congress needs to find a way to eliminate frivolous malpractice cases.

Read more at the WSJ.