Do Physicians Practice Defensive Medicine? New Empirical Evidence
This session collects three studies of “defensive medicine,” which can be broadly defined as medical practices that protect physicians from malpractice lawsuits with minimal, no, or negative benefit to patients. The welfare loss from defensive practices is often asserted to be important. In this session, we present three papers that study the effect of multiple policies on defensive medicine. Two papers analyze the effect of caps on non-economic damages, which are intended to limit malpractice suits, on specific tests and procedures that are likely to be sensitive to med mal risks, as well as overall Medicare spending. The third paper is a case study of the effect of a communication-and-resolution programs on defensive practices. Communication and resolution programs are intended to address adverse patient safety events proactively by recognizing the injury, disclosing information about the adverse event to patients, and offering an apology and remediation if warranted. The first paper (Moghtaderi, Black, and Farmer) uses patient level data to analyze the effect of damage caps tort reforms on overall spending and rates of cardiovascular imaging among Medicare patients. The second paper (Li and Dor) studies the effect of damage caps and other tort reforms on diagnostic X-ray imaging tests. The third paper (Helmchen, Lambert and McDonald) investigates the effect of a communication-and-resolution program on radiology procedures and length of stay for patients with chest pain.