‘Defensive medicine’ can come with price

The price of medical care is getting more expensive each year, whether it is the cost of co-pays for drugs and office visits or increasing insurance premiums.

One significant factor driving up costs is that one in every four health care dollars spent annually is for tests and procedures that aren’t necessary. This is often referred to as the practice of “defensive medicine.”

Patients experience defensive medicine when they are sent for lab work, X-rays, biopsies, CT scans or MRIS that aren’t really needed.

Doctors order these unnecessary tests, medications, procedures and even hospitalizations to protect themselves from lawsuits.

Recently, The New York Times reported that a group of nine medical specialty boards issued a set of recommendations that doctors cut back on at least 45 tests and procedures that aren’t necessary in most cases.

Another eight specialty boards are expected to offer a list of procedures, tests and treatments it will ask its doctors to consider using less fre- quently.

The blunt suggestions come as these groups say that too many tests are harmful to patients — let alone what it does to the cost of medicine.

For example, the groups advise against EKGS during a routine physical when there are no signs of a heart condition or ordering an expensive MRI just because a patient complains of back pain.

Patients for Fair Compensation, a Georgia-based nonprofit, issued a report this winter that showed $13.25 billion a year is spent on unnecessary medical tests and procedures in Georgia. It also found that $700 million in taxpayer money could be saved on Medicaid in the state if it were to eliminate defensive medicine.

As a former professor of emergency medicine, I can tell you that medical schools teach defensive medicine so physicians can protect themselves against patients who might sue for a missed diagnosis.

Physicians are also pressured by patient demands. Our culture has taught us that “more” is often better. But sometimes in medicine, more isn’t always better. Sometimes the body has to heal itself without so much poking and prodding.

Patients also feel they cannot get well without taking advantage of all the new technology to diagnose their illness.

However, 85 percent of the time, a well-trained doctor who is briefed on a patient’s medical history, paired with a thorough exam, can be just as successful in treating most conditions.

Ordering a battery of exams is often just a way to alleviate a physician’s fears about potential litigation from frivolous lawsuits.

The trade-off in society is that all of us have to endure more testing and medical procedures until we have fixed our broken medical tort system.

Dr. Sam Kini of Smyrna is a former professor of emergency medicine at Emory University School of Medicine.