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‘Defensive medicine’ behaviors prevalent among US neurosurgeons
Among neurosurgeons in the U.S., researchers found both avoidance and assurance behaviors are prevalent and are correlated with subjective and objective measures of state-level liability risk.
The researchers sent a 51-question online survey to 3,344 U.S. neurosurgeon members of the American Board of Neurological Surgeons (ABNS). The anonymous survey was conducted during the course of 6 weeks in 2011 and contained questions on neurosurgeon, patient and practice characteristics; perceptions of the liability environment; and defensive-medicine behaviors. Using bivariate and multivariate analyses, the researchers examined the state liability risk environment as a predictor of a neurosurgeon’s likelihood of practicing defensive medicine.
Thirty-one percent of neurosurgeons responded to the survey. All of the participants had an average of approximately one claim against them during the previous 3 years, whereas those in high-risk states (medical-legal risk grade of D or F) were almost twice as likely to have a claim made against them, according to the researchers.
Survey results also demonstrated that the majority of neurosurgeons had participated in some form of defensive medicine, with more than eight out of 10 neurosurgeons having ordered imaging solely for defensive purposes, more than 75% reported to have ordered laboratory tests and making extra referrals for defensive purposes, and between 40% and 50% who claimed to order more medications and procedures out of the fear of being sued.
Additionally, almost half of neurosurgeons in high-risk states noted they avoided procedures or patients because of liability concerns. – by Robert Linnehan
Disclosure: The authors have no relevant financial disclosures.