Aug. 6—Medicare patients receive more diagnostic tests and emergency department (ED) referrals when treated by physicians who are very concerned about malpractice liability, regardless of whether states have adopted common malpractice tort reforms, according to a study by researchers for the Center for Studying Health System Change.

The study, published in the August issue of Health Affairs, compared office-based physicians’ concerns about malpractice liability with the number of tests ordered and ED referrals made for elderly Medicare patients with new complaints of chest pain, headache, and lower-back pain, based on claims data. Across the conditions, patients whose physicians reported higher levels of malpractice concern received more services, the study found. 

The study found that physicians’ perception of their risk for malpractice liability—rather than their actual risk—can influence their practice of “defensive medicine.” For example, elderly Medicare patients with chest pain were more likely to be referred to the ED if their physician had a high or medium level of malpractice concern, according to a release on the study. Likewise, patients with a headache were more likely to receive a CT or MRI scan if their physicians had high levels of malpractice concern.

Publication Date: Tuesday, August 06, 2013