The hidden costs of defensive medicine


They soon realized that in a court of law, complex medical cases were left to the judgment of juries, the vast majority of whom were incapable of understanding the complexities of the issues they were tasked to adjudicate.

These developments directly affected health care costs when physicians were forced to change their practices to protect themselves. For example, physicians may be 99 percent certain that they have accurately diagnosed a patient’s medical problem, but to be absolutely certain they’ll order complementary (albeit unnecessary) diagnostic tests to cover all the bases.

Consider the dilemma faced by an emergency room physician who receives a patient he has never seen before. The patient may be suffering from no more than a common cold, but the physician may be forced to order lab tests, X-rays and expensive studies simply to avoid a lawsuit.

While admittedly there are some cases where lawsuits are warranted, there are numerous cases where lawsuits are frivolous and inappropriate. Many awards not only include “compensatory” damages, which are designed to compensate a patient for the costs of the actual treatment to restore their health and actual losses of employment, but also include huge awards for “punitive” damages that are purportedly to punish the physician or hospital.

Under our current system of law, “joint and several liability” stipulates responsibility for judgments and awards is shared equally between the involved parties based on their ability to pay. In a case where an injured patient has no insurance and one could reasonably argue that he was more than 95 percent liable for his own injuries, the full amount of an award would be assessed on the hospital or physician who may have only 5 percent of the blame. Is that fair?

Proponents of the current malpractice system will point out that the total amount of malpractice judgments and awards account for a negligible amount of total health care costs. But they don’t address the costs of the defensive medicine. Many people don’t realize that physicians’ fees are inflated as a result of the professional liability insurance premiums they must pay. Recent studies show that the costs of defending against a malpractice claim in Florida exceeds $100,000 even if the physician is adjudicated innocent.

For certain specialties in Florida, malpractice premiums exceed $175,000 per year. That’s more than $3,300 per week payable even when they’re on vacation! The cost of these premiums is passed on to patients.

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