While a new study has found that increased physician spending in a hospital setting results in fewer malpractice claims, more research needs to be done before the medical community reacts, Weill Cornell Medicine researchers write in a new commentary, published Nov. 4 in The BMJ.
The commentary notes that the study, which was conducted by Harvard Medical School researchers and published in The BMJ, is the first of its kind to consider how spending relates to malpractice risk.
"When I talk to physicians, they always want to know how they can lower their malpractice risk," said Dr. Tara Bishop, an assistant professor of healthcare policy and research who's studied malpractice for years. "While they might interpret these results to mean that if they spend more money and practice defensively they will decrease their risk, that has not yet proven. But the results are quite interesting and more research should be done to explore how spending affects malpractice risk."
Dr. Bishop and her colleague, Dr. Michael Pesko, also an assistant professor of healthcare policy and research, presented three points that might be followed up on in future work. The first would involve finding out if the increased spending was a result of ordering more — and sometimes unnecessary — tests and procedures to stave off potential malpractice claims, a practice known as defensive medicine, or the result of providing better and safer care.
"An estimated $60 billion is spent annually on defensive medicine," Dr. Bishop said, "and the assumption has been that this is wasteful. This is the first study to challenge that assumption."
But Dr. Bishop cautions that because this study doesn't separate defensive spending from necessary spending, it's challenging to interpret the results. The study, which followed 19 million hospitalizations in Florida from 2000 to 2009, only looked at the impact of spending on lawsuits. It didn't consider the affect the increased spending had on medical errors or adverse events, or look back at the history of the included 24,637 physicians across seven specialties to see if they had been sued before, or had another reason for spending more.
For all of these reasons, "it's too early to say whether or not defensive medicine protects doctors against malpractice claims," Dr. Bishop said. "But this study uncovered some interesting data that's worth following up on."