Do doctors prescribe antibiotics out of fear of malpractice?

Abstract

This paper studies whether doctors prescribe antibiotics to protect themselves against potential malpractice claims. Using data from the National Ambulatory Medical Care Survey on a representative sample of doctor visits from 1993 to 2011, I find that doctors are significantly less likely to prescribe antibiotics following tort reforms that reduce malpractice pressure. The changing prescribing patterns appear to have no adverse effects on patient health outcomes over the same time period. Almost 100 million hospital records from the Nationwide Inpatient Sample reveal little to no effects of tort reforms on hospital stays involving conditions that can potentially be avoided through the timely use of antibiotics. Taken together, these findings suggest that malpractice pressure induces doctors to prescribe antibiotics that are medically unnecessary, thereby contributing to the rise in antibiotic resistance.

How Might Antibiotic Stewardship Programs Influence Clinicians’ Autonomy and Organizations’ Liability?

“…There are several possible patient scenarios, of varying plausibility, out of which a malpractice suit might arise 15,16,17 : (1) patients who allege that they were inadequately treated because of an antibiotic or lack thereof, (2) patients who allege that they suffered harmful side effects because of an antibiotic, and (3) patients who allege that they suffered an infection from a resistant organism that would have otherwise been preventable but for insufficient antibiotic stewardship.…”