NASE News

Study Finds Some Doctors Order Unnecessary Tests Because Of Malpractice Fears

A study recently released by the medical journal Circulation: Cardiovascular Quality and Outcomes found that about one in four heart doctors say they order medical tests that may be unnecessary because they are afraid of being sued.

The study surveyed close to 600 doctors to determine how aggressively they treat their patients, and if their decisions to order invasive heart tests are influenced by non-medical issues.

Most of the doctors surveyed indicated that their decision to order a test was not influenced by things like financial gain or a patient’s expectations. However, about 24 percent of those surveyed said they had recommended a test in the previous year because they were worried about malpractice lawsuits, and 27 percent said they recommended a test because they thought their colleagues would.

The study asked doctors to recommend tests and treatment for three hypothetical heart patients. Their responses were used to score them on how aggressively they tend to treat patients. The doctors were also asked whether other issues had led them to recommend the heart test – called a cardiac catheterization – during which a thin tube is threaded to the heart to check how it is functioning and look for disease.

Comparing the scores to Medicare records, the researchers found that doctors with higher scores were more likely to practice in regions with higher spending overall or higher rates for cardiac catheterization, although the differences were small.

The survey was conducted to see whether doctors’ attitudes and practices might be contributing to the wide differences in health care use and spending across the country.

The researchers suggest that targeting malpractice concerns would help reduce regional differences in health care spending and use. Although medical malpractice was discussed during the health care debate, no malpractice provisions were included in the new health care reform law.

The lead author of the study said patients can help rein in health spending by not pressuring their doctors to do tests.