Right Diagnosis, Wrong Cure

August 8, 2012
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Writing in The New York Times, Sanjay Gupta notes that defensive medicine leads doctors to order tests and procedures that can cause other errors:

In a recent anonymous survey, orthopedic surgeons said 24 percent of the tests they ordered were medically unnecessary. This kind of treatment is a form of defensive medicine, meant less to protect the patient than to protect the doctor or hospital against potential lawsuits.

Writing in The New York Times, Sanjay Gupta notes that defensive medicine leads doctors to order tests and procedures that can cause other errors:

In a recent anonymous survey, orthopedic surgeons said 24 percent of the tests they ordered were medically unnecessary. This kind of treatment is a form of defensive medicine, meant less to protect the patient than to protect the doctor or hospital against potential lawsuits.

Herein lies a stunning irony. Defensive medicine is rooted in the goal of avoiding mistakes. But each additional procedure or test, no matter how cautiously performed, injects a fresh possibility of error. CT and M.R.I. scans can lead to false positives and unnecessary operations, which carry the risk of complications like infections and bleeding. The more medications patients are prescribed, the more likely they are to accidentally overdose or suffer an allergic reaction. Even routine operations like gallbladder removals require anesthesia, which can increase the risk of heart attack and stroke.

But Gupta misses the obvious solution: don’t have a medical malpractice system that compensates patients only for adverse events found to constitute “malpractice.”  Instead, have a voluntary no-fault system that compensates for all adverse events — regardless of cause.