Does 'Defensive' Medicine Differ From 'Careful' Medicine?

Mark Crane


March 10, 2015

In This Article

Doctors Sound Off on Defensive Medicine

Physicians had lots to say about defensive medicine in Medscape's recent Ethics Report. Some say they reluctantly practice defensive medicine. Others insist that it's never justified.

"On occasion, I have gone further with diagnostic testing than I thought really necessary because the patient or family was hostile and likely to be quick to sue."

"There is more and more push to avoid doing CT scans and some labs. The one time I did wait, the patient ended up having a subdural [hematoma], and I wished I had ignored all those new guidelines."

"Unfortunately I work in a very litigious state and have done this. I try not to do anything that would put the patient at risk, but I do practice defensive medicine, as do all my colleagues. It consumes us."

"We do it all the time in the ER. I don't really need that CBC, nor does the patient (usually a child). But do I trust the legal system to see that? Hell no!"

"People who say that defensive medicine only accounts for a tiny fraction of the healthcare costs in the United States are completely delusional or political ideologues."

"Evidence-based medicine is the best defense against a malpractice claim, not defensive medicine. Be true to our training."

"Screw malpractice. Do what is right for the care of the patient."

"If it's not warranted, it is not warranted, regardless of malpractice or other concerns."

"Malpractice fear should not be a motivation for treatment decisions. Appropriateness and necessity for the patient are paramount."

Whatever the many viewpoints, as long as malpractice lawsuits are still a large part of life, defensive medicine is not likely to go away any time soon.


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