"Defensive Medicine," Nonsense

Repeat after me, "Doctor, why are you ordering this test?"

Simple. To the point. You should receive a straight forward, clear and concise answer to this question every time. When you pose this question to your physician you are doing two helpful things: (1) You are participating in and learning about your own health care, and (2) you are helping to reduce the overall cost of health care, which helps everyone.

Many doctors are blaming the perceived need to practice "defensive medicine" as a significant contributor to ever increasing medical costs. Their argument is that out of fear of getting sued they feel compelled to order tests for their patients that are not really necessary. Apparently, the logic behind this is that if it seems that the doctor is doing something to care for his or her patient, even if unhelpful or nonsensical, then if the patient ends up with a bad outcome the doctor will not get sued. This approach to medicine is stupid for two reasons: First, the doctor is not protecting himself or herself from liability in the slightest by ordering unnecessary tests or procedures. Secondly, and more importantly, the physician is exposing the patient to undue risk.

In Illinois a physician may be found liable for medical malpractice or medical negligence (they mean the same thing) when he or she fails to act as a reasonable physician would under the same or similar circumstance. At a medical negligence trial, a jury determines what was reasonable under a given set of circumstances by listening to the testimony of experts who practice medicine in the same field as the defendant doctor. To offer an obvious example, if called upon to amputate one of a patient's legs, a surgeon would reasonably be expected to check the chart to determine whether the left or right leg needed to be removed. In that circumstance, a failure to do so resulting in the patient having the wrong leg amputated amounts to medical negligence. Under the law, ordering unnecessary or unhelpful tests does nothing to protect a physician from liability. A reasonable physician must perform procedures and order testing appropriate to the circumstances. A failure to do so which results in harm is medical negligence. Furthermore, many diagnostic tests and procedures come with risks. For example, contrast dye sometimes used in CT scans can bring about a significant allergic reaction. A colonoscopy can result in a perforated colon. Patients should not shy away from these usually safe procedures, but they should not be done unnecessarily either.

When it comes right down to it "defensive medicine" is a nonsensical term. It's just another phrase that means negligent medicine.