	Estimates of the extent and cost of defensive medicine vary widely. This should come as no surprise, given that physicians, consultants, and academics who study the practice of medicine don’t always agree on how to define the term.

	In May 2011, for example, the Web site DefensiveMedicine.org cited surveys by healthcare staffing company Jackson Healthcare and the Gallup polling organization indicating that defensive medicine costs the United States $650 billion to $850 billion annually.

	In December 2010, the American Academy of Orthopedic Surgeons cited estimates that, by reducing defensive medicine, liability reform could result in yearly savings from $54 billion to $650 billion.

	Closer to the trenches, Edmund Funai, MD, professor of obstetrics/gynecology at Ohio State University in Columbus, Ohio, and chief operating officer of the OSU Health System, thinks defensive medicine exacts a huge, largely unmeasured financial cost. The example he cites is shoulder dystocia, calling it “by and large a rare but unpreventable consequence of childbirth.” The average malpractice settlement for shoulder dystocia in Connecticut, he says, is $1.2 million.

	Cesarean section (C-section) is seen as providing protection from liability for shoulder dystocia, says Funai, who ties that to the fact that to the 40% increase in the number of C-sections in the past 10 years. “There’s no doubt that c-section is overused in the United States,” and fear of being sued for shoulder dystocia is one of the reasons, he says.

Legal

Practice Management

Although estimates for how much is spent on defensive medicine vary widely, experts agree that the dolllar amount is large.