The Defensive Practice of Medicine: Myth or Reality

Hershey, Nathan

doi:10.2307/3349487

Cited by 43 publications

(25 citation statements)

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“…There have been various estimates of these costs, ranging from $3-$6 billion in 1975 to $15-$40 billion in 1983 (Reynolds et al 1987), although other studies question these high estimates. Hershey's (1971) early interview study suggested that doctors were using some extra diagnostic tests as defensive medicine, but the total cost of these tests was quite small. Another study, by the editors of the Duke Law Journal, also questioned the widespread existence of defensive medicine (Special Project 1971).…”

Section: Journal Of Health Politics Policy and Lawmentioning

confidence: 99%

Practice Guidelines and Malpractice Litigation: Collision or Cohesion?

Brennan¹

1991

Journal of Health Politics, Policy and Law

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Practice guidelines are standardized specifications for managing particular clinical problems and are intended to improve the outcomes of medical care by increasing adherence to standards of care. They are also meant to make medicine more cost-effective by eliminating unnecessary procedures. A relatively recent phenomenon, the practice guidelines now emerging will have implications for malpractice, which also intends to bring about better care. They will probably not revolutionize the procedures that courts use to determine negligence, but judges will integrate guidelines into their decision-making process. This development should be welcomed. Guidelines should prove to be useful as either inculpatory or exculpatory evidence of negligence. They are unlikely to generate much new litigation, although there is some potential for suits against those who issue guidelines, especially if guidelines are not revised as the technology of medical care changes.

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Section: Journal Of Health Politics Policy and Lawmentioning

confidence: 99%

Practice Guidelines and Malpractice Litigation: Collision or Cohesion?

Brennan¹

1991

Journal of Health Politics, Policy and Law

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“…The number of medical malpractice lawsuits increased 300% between 1965 and 1970 [12]. Jury verdicts and out of court settlements awarding millions of dollars to plaintiffs because of physicians' negligence in failing to order radiologic imaging and other tests began increasing in geometric fashion in the 1970s.…”

Section: Medical Negligence Evolves From Errors Of Commission To Erromentioning

confidence: 99%

“…Their motivation to keep ordering more was further strengthened by the public's almost insatiable appetite in demanding radiologic and non-radiologic tests for screening, minor symptoms, and all varieties of medical illness. The threat of liability began to strongly influence the day-to-day practice of virtually all physicians [12].…”

Section: Medical Negligence Evolves From Errors Of Commission To Erromentioning

confidence: 99%

Medical errors, malpractice, and defensive medicine: an ill-fated triad

Berlin

2017

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For the first 180 years following the founding of the US, physicians occasionally were sued for medical malpractice. Allegations of negligence were errors of commission -i.e. the physician made a mistake by doing something wrong, usually mistreatment of a fracture or dislocation, a complication or death following a surgical procedure, prescribing the wrong medication, and after the discovery of the X-ray by Roentgen in 1895, causing radiation burns. In the mid twentieth century malpractice allegations slowly changed from errors of commission to errors of omission -i.e. the physician failed to do something right: almost always, failed to make a diagnosis. The number of malpractice lawsuits increased at a geometric rate beginning in the 1960s, and in the 1970s physicians began practicing defensive medicine, which lead physicians to order unnecessary radiology exams and tests. In the past 20 years the number of malpractice lawsuits has been decreasing, but the practice of defensive medicine has continued. Unnecessary exams and tests increase the likelihood of overdiagnosis and overtreatment, i.e. a new kind of error of commission.

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“…Organized medicine has recently be- Shortell, 1973Freidson, 1960Goode, 1957Shaw. 1972Coleman, et al, 1966Stone, 1974Stebbins, 1966Shover, 1972Scheff, 1961Useem, 1976Caplow & McGee, 1958Gustafson, 1975Hershey, 1973Haas, 1974Marro, 1977Cohen, 1973Graves. 1970Hall, 1948Hall.…”

Section: Occupational Expansionismmentioning

confidence: 99%