New bill seeks to end unique U.S. practice: Defensive medicine

Practicing defensive medicine may be an activity unique to the United States, according to a report by a healthcare staffing company that recently surveyed physicians in four other countries.

Jackson Healthcare contacted 200 randomly selected physicians in the United Kingdom, New Zealand, Canada, and Sweden and found that none of them reported practicing defensive medicine, which was defined as the ordering of medically unnecessary tests, treatments, or consultations to avoid lawsuits.

“The reason physicians in other countries don’t make medical decisions to avoid lawsuits is that they are not personally financially liable for errors,” says Richard Jackson, chairman and chief executive officer of Jackson Healthcare. “They enjoy protections under their medical malpractice systems that U.S. physicians don’t.”

Those findings are in contrast to a 2009 survey in which Jackson Healthcare found that 92% of U.S. physicians admitted to making medical decisions to avoid lawsuits. In 2010, Jackson Healthcare commissioned the Gallup organization to do a similar survey, which found that physicians attribute 26% of overall healthcare costs to the practice of defensive medicine. Of the physicians surveyed, 73% agreed that they had practiced some form of defensive medicine in the past 12 months.

A doctor in Congress is attempting to do something about that with a bill he calls the “Health Care OverUse Reform Today Act (HealthCOURT Act). Rep. Tom Price, MD (R-Georgia), recently introduced a bill to “establish performance-based quality measures, to establish limitations on recovery in healthcare lawsuits based on compliance with best practice guidelines, and to provide grants to states for administrative healthcare tribunals.”

The bill, which was referred to the House Committee on Energy and Commerce, does the following:

• Offers protections for healthcare providers who practice medicine consistent with best practice guidelines selected by the Secretary of Health and Human Services after securing approval and endorsement by a physician specialty organization and a qualified physician consensus-building organization.
• Provides state grants for the creation of administrative healthcare tribunals that would hear cases only after they are reviewed by an expert panel with at least one-half of the members consisting of medical experts.
• Allows all parties to maintain the ability to file a claim with a state court after exhaustion of the administrative remedies. 

“The practice of defensive medicine adds billions of dollars of unnecessary costs to our healthcare system and diverts doctors' focus away from delivering quality care,” Price, an orthopedic surgeon, said in a statement.

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