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March 16, 2010

Defensive Medicine Doesn’t Lead To Unnecessary Medical Treatment

For every injury or illness, there are a range of possible treatments. The (very crude) drawing below represents that range. At the left end of the scale is to “do nothing” and see if the injury gets better on its own. At the far right end of the scale is immediate surgery to try and correct the problem. The bracket in the middle represents treatment within the permissible standard of care for a hypothetical injury. For this hypothetical injury, it would be inappropriate to do nothing, and it would also be inappropriate to take the patient to surgery immediately. Medically appropriate treatments might include administering drugs, ordering an inexpensive diagnostic test, and ordering an expensive diagnostic test. Doctor Smith may be conservative with his treatment and decide to order an inexpensive diagnostic test, while Doctor Jones may be aggressive and order the administration of drugs and the expensive diagnostic test. While both doctors treated the same injury in different ways, neither doctor committed malpractice. More importantly, if Doctor Smith is afraid of being sued and orders the expensive test, we cannot say that his fear of being sued led him to order a medically unnecessary test. The worst we can say is that the tort system nudged the doctor towards being more cautious.


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