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PJM Lifestyle

Defensive Medicine Kills

Not just snake oil wasting our money, but an actual snake quietly poisoning us.

by
Dr. Peter Weiss

Bio

July 27, 2012 - 2:07 pm

 

Have you ever had a headache? Have you ever had diarrhea? Have you ever taken aspirin?

If so, you may be entitled to compensation for complications from taking aspirin. Call us now. We don’t get paid until you do, and then we take 40%. Why risk your hard-earned money on work? Come roll the dice. It’s free. It’s America.

Okay, maybe I got a little carried away there, but not by much. Late night TV ads now solicit “clients” who have had “complications” from some sort of medical treatment. Never mind that “complications” does not equal malpractice. Life is a complication. Malpractice is supposed to be just that, not maloccurrence.

This problematic scenario forces physicians to practice defensive medicine. This has nothing to do with what’s the best medicine, only with what trial lawyers have forced us to do. Defensive medicine has become “standard of care.”

The true cost of defensive medicine is hard to pinpoint. Estimates range from between 10% and 25% of every health care dollar spent. Many of us believe it may even be higher.

Defensive medicine not only costs us a hell of a lot of money, it may also kill us! Doctors call for more than 62 million CAT scans annually in the USA. According to a 2007 New England Journal of Medicine article, one-third were probably unnecessary. Again, many physicians feel that may be an underestimate.

Here comes the real kicker. The radiation dose from a single CAT scan is 500 times that of a plain chest X-ray.

According to that same NEJM article, it’s estimated that 1.5% to 2% of all cancers in the USA in the next few decades may relate to radiation from CAT scan studies. You can blame the doctors all you want, but we are pressured to “overkill,” both literally and figuratively.

Reminds me of  that old cartoon. The patient rests in the hospital bed with his lawyer lying next to him. The doctor asks the patient: “How are you today?”

And the lawyer answers.

We hear much about the number of deaths from “medical errors.” This narrative began when an Institute of Medicine article stated that medical errors cause up to 98,000 deaths a year in U.S. hospitals. This received huge play in the mainstream media. While any medical error is bad — and sometimes tragic — they do not occur to the extent reported. The original report relied on a study from 1991. Only a small subset (27%) referred to negligent or substandard care. That still leaves the number of medical error deaths at a staggering 27,000, but the remainder of these adverse events were normal complications of medical and surgical care, such as infection and post-surgical bleeding. There we go again with “complications” equaling malpractice.

The other neglected point: how many “complications” were due to care in a teaching institution or training program? This study also failed to consider the quality of outpatient facilities or private medicine.

This brings me back to the problem at hand: Obamacare. (You knew I would find a way to knock the Unaffordable Care Act!)

The president’s signature legislation ignores defensive medicine. We are not only wasting up to 25% of a 2 trillion dollar industry, we may actually be harming ourselves at the same time.

At what point is it not worth it for a doctor to be a doctor? A recent survey found that 83% of physicians said that they would strongly consider retiring from the practice of medicine if Obamacare was fully implemented.  More studies show that a large percentage of physicians would not choose our current profession if we had the ability to do it all over again. If the goal of the administration is to destroy health care and lower it to the most common denominator, it’s doing a good job!

As I have called for in other articles, it is time to implement the “English System,” or the loser-pay system. It may not be perfect, but it’s simple and easy to implement. It does not take away the God-given right of Americans to sue. And it doesn’t take away the right of trial lawyers to continue to run ads telling you that you may be entitled to compensation f you’ve had an erection for longer than four hours.

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More on health and medicine at PJ Lifestyle:

Theodore Dalrymple: Should You Take Antibiotics?

Theodore Dalrymple: Can Dark Chocolate Reduce High Blood Pressure?

Dave Swindle: Overcoming Junk Food Consciousness

Thumbnail image and illustration courtesy shutterstock / Michael Bann

Peter Weiss M.D., F.A.C.O.G., is Director and Founder of The Rodeo Drive Women's Health Center. He is also Assistant Clinical Professor of OB/GYN at The David Geffen School of Medicine at UCLA. He was health care adviser to John McCain's presidential campaign. Dr Weiss is an Attending physician at Cedars Sinai and St Johns Health Centers
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