Physicians’ concerns about malpractice risk predict more aggressive diagnostic testing practices in office-based care, according to a study published in Health Affairs.

Emily R. Carrier, M.D., from the Center for Studying Health System Change in Washington, D.C., and colleagues utilized physicians’ responses regarding their levels of malpractice concern as reported in the 2008 Health Tracking Physician Survey and linked those findings to Medicare Parts A and B claims for the patients they treated from 2007 to 2009.

The researchers found that physicians who reported a high level of malpractice concern were most likely to engage in practices that would be considered defensive. This was seen in diagnosing practices for patients who visited their offices with new complaints of chest pain, headache, or lower back pain. There was no consistent relationship seen when state-level indicators of malpractice risk replaced self-rated concern.

Continue Reading

“Reducing defensive medicine may require approaches focused on physicians’ perceptions of legal risk and the underlying factors driving those perceptions,” the authors write.