Doctors' practice of "defensive medicine" widespread, costly

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EruditePaul
Regular Member


Date Joined Jan 2006
Total Posts : 266
   Posted 11/17/2008 6:55 PM (GMT -7)   

The Massachusetts Medical Society surveyed 900 of its members, including family doctors, obstetricians and gynecologists and general surgeons, who reported practicing so-called "defensive medicine."

The report found that 83 percent of physicians surveyed reported practicing defensive medicine and that an average of 18 to 28 percent of tests, procedures and referrals and consultations, and 13 percent of hospitalizations were ordered solely out of fear of being sued.

Here is the full article:

http://www.boston.com/news/health/blog/2008/11/doctors_practic.html


Diagnosed with CD in 1994;

In 1994 I was treated with Pentasa of no avail.  Have being treated with Chinese herbal medicines for over 10 years.


Margie11
Regular Member


Date Joined Aug 2008
Total Posts : 467
   Posted 11/17/2008 8:16 PM (GMT -7)   

 

Paul,

  This is frightening. It reminds me that if my family doctor makes a honest mistake, he cannot even explain or apologize for his mistake. It makes for huge trust issues, when the relationship can be life or death for some of us. In our state, lawmakers are working for tort reform, but that lets them off the hook cheeply, even if it is a not so honest mistake. There are no easy answers.

 


              Never go faster than your guardian angel can fly!                  
     Be Patient And Tough, Someday This Pain Will Be Useful To You 
 
 Crohn's for life, symptoms included terrible joint and soft tissue pain, just met first cousin who suffers from Reactive Arthritis-explains sooo much. Great control on SCD (when I'm good) and I get by with a lotta help from my friends!
                                                Margie11

Post Edited (Margie11) : 11/18/2008 10:03:05 AM (GMT-7)


Texan with Crohn's
Regular Member


Date Joined Dec 2007
Total Posts : 362
   Posted 11/18/2008 5:17 AM (GMT -7)   
Just read through the information you posted. We are such a litigious society. It is a shame that everyone must suffer from the actions of a few. Perhaps when seeing a doctor I should now make an opening statement that I have no plans to file a lawsuit. :)

Thanks for this info.

broomhilda
Veteran Member


Date Joined May 2007
Total Posts : 1488
   Posted 11/18/2008 5:25 AM (GMT -7)   
Read my post of "Angry, Hurt and Depleted" which I posted yesterday if you haven't already.  It pretty much sums up the "treatment" I received that is so very relavant to your post.  I am still in tears and have decided I am way too emotional to make a rational decision right now.

MikeB
Veteran Member


Date Joined Mar 2006
Total Posts : 1169
   Posted 11/18/2008 6:07 AM (GMT -7)   

This is an issue I have worked on in the public policy arena and it one of the most frustrating things in our society. Essentially, the courts and the legal profession insist on regarding the practice of medicine as a science, when in fact it is an art. They expect predictable outcomes when, as all Crohnies know too well, each patient is unique and each disease course distinctive. So we have grafted a "we know what should always happen and we will sue anyone involved in a varient outcome" legal expectation on a field where the reality is that there are no absolute certainties and no assurances that everyone will get well every time. The prototype was the explosion of costly lawsuits in cases of cerebral palsy .  . . doctors were being held accountable for tens of millions of dollars for "causing" CP, when in fact there was no real evidence that CP was anything other than bad luck in many cases. The result? More C-sections as defensive medicine, higher costs, longer hospital stays, etc.

There is room for adequate compensation in cases of true medical malpractice resulting in real harm from actual, provable negligence. . . but those cases are only a small fraction of those filed and settled. The norm is more like the CP casesd above, or the sometimes preposterous ones we all read about. Expecting perfection from an imperfect field is always self-defeating. Next time you get a bill for some tests you probably did not need, thank a lawyer . . .


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 11/18/2008 9:23 AM (GMT -7)   
I am so tired of having doctors pat me on the knee and say well there is really nothing wrong (do guys get this?), especially since now I can prove there really was something very wrong and they did nothing about it.

just a zebra...


Forum Co-moderator - Crohn's Disease
...I will find a way, or make one. -Philip Sidney 1554-1586
Make sure your suffering has meaning...
All suggestions/options/opinions are caveated with please consult with your local health care provider...

Post Edited (MMMNAVY) : 11/18/2008 9:59:11 AM (GMT-7)


EruditePaul
Regular Member


Date Joined Jan 2006
Total Posts : 266
   Posted 11/18/2008 9:55 AM (GMT -7)   

Those unnecessary tests, ordered out of "defensive medicine", not only increased the health care costs, but also exposed patients to harmful radiations and other side effects. 

MRI contrast side effects could lead to a painful and disfiguring disorder for those with kidney problems or impaired renal function.  Nephrogenic Systemic Fibrosis, also known as Nephrogenic Fibrosing Dermopathy (NFS/NFD), is a progressive disease which has been observed in kidney patients after receiving a gadolinium based magnetic resonance imaging (MRI) contrast agent. 


Diagnosed with CD in 1994;

In 1994 I was treated with Pentasa of no avail.  Have being treated with Chinese herbal medicines for over 10 years.


LMills
Veteran Member


Date Joined Apr 2008
Total Posts : 1753
   Posted 11/18/2008 10:33 AM (GMT -7)   
It's a shame those who deserve some sort of 'punishment' can't always be distinguished from those who don't. And it's an even bigger shame that there are patients who make it harder for the rest of us because the seek out any significant reason to cash in on their doctor's 'maltreatment.'
20 years old, Diagnosed with moderate to severe Crohn's and Colitis in May of 2008.
Currently taking:
Prednisone(down to 10 mg), pentasa, bentyl as needed, prilosec, tandem plus, humira, and good probiotics
Surgery for ectopic pregnancy most likely the result of severe Crohn's inflammation in July of 2008.
http://weblog.xanga.com/harlequin_garret


broomhilda
Veteran Member


Date Joined May 2007
Total Posts : 1488
   Posted 11/18/2008 12:00 PM (GMT -7)   
Those that come last will be first. Remember we only have a promise and opportunity of today...not tomorrow, not next week, not next year. Base all your ethical decisions on that and you won't be left behind. No matter what the heck the lawyers and medical community does to us all.

Paul- I can tell you from personal experience that ever since I had a kidney stent placed at my resection and numerous CT scans with contrast my kidneys do not function as they once did. Dysfunctional everything seems to be my new normal. If you've read any of my posts lately regarding my upcoming oral surgery, I was also subjected to yet another CT scan this weekend...this one of the head. Guess they finally decided I was so stupid to all the red tape surrounding our treatment, I must have totally lost my mind! The tech had to add his personal unsolicited opinion of "aren't you a little old to be cutting teeth" to further assess the situation. So I guess if as a doctor, you know what you're doing fine, if not, you are human too. Be a big enough person to know when you are over your head and maybe just maybe, think outside the box and offer your patient options and maybe then the responsibility lies with the patient for medical decisions where the liability should have been in the first place! Sorry this post has a negative tone. I'm just having a bad day!
Dx'd Jan'06, 1st Resection 7/06, Humira, Imuran, B12 injections, Nexium, Lexapro, Nulev, Glucosamine, Multi-Vitamin, Calcium Citrate, Ultracet. Secondary conditions: Psorasis, Osteoarthritis, Fibromyalgia, Lactose Intolerant, gallstones, kidney stones & peri-menopausal.


CrohnieToo
Veteran Member


Date Joined May 2003
Total Posts : 9448
   Posted 11/18/2008 4:33 PM (GMT -7)   
Well, the medical profession brought a lot of it upon themselves by looking the other way or even covering for the bad apples in the profession for years. From one extreme to the other.
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.


FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 11/18/2008 5:49 PM (GMT -7)   
Well I disagree with the majority on this one but maybe because I am a future lawyer - but keep in mind, as of now I have only DEFENDED doctors, not prosecuted them - so I do think I can be unbiased. Anyone can sue anyone for anything but the bigger question is if they will be successful. There have been people injured on this board who were told that they would not have a succesful suit. There is actually a high standard to meet. You have to show that your doctor deviated from his/her standard of care and that you were injured as a result. So you go in with persistent headaches. The doctor can take the cheap route and say "stress" and tell you to wait it out. Or the doctor can be proactive and send you for a cat scan to make sure that you don't have a tumor. Catching something early leads to the most succesful treatment. If there was an inkling that I could have a disease or problem and my doctor could test me to rule that out, I would expect him to do so. And if he decided not to tell me that there was a chance that I had cancer and decided not to send me for a cat scan because it was expensive and then I would up w/ stage 2 or 3 cancer instead of stage 1, I would want him held accountable. Yes medicine is an art - but there are some things that are basic science. I think we would all agree that if someone was presenting w/ rectal bleeding we would want them to have tests - not just have the doctor say "you probably have hemmroids" and not mention the 5% chance of crohns.
27 Year old married female law student (last year!!). Diagnosed w/ CD 4 years ago, IBS for over 10 years before that, which was probably the CD. I am sort of lactose intollerant too but can handle anything cultured and do well w/ lactose pills and lactaid. For crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn. I also have bad acid reflux and have been on PPI's since age 13. I have been through prilosec, prevacid, and nexium. Currently I am on Protonix in the morning and Zantac at night. I also take a birth control pill to allow some fun in my life.


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 11/18/2008 5:55 PM (GMT -7)   
That is pretty much what happened to me Fitzy.
Forum Co-moderator - Crohn's Disease
...I will find a way, or make one. -Philip Sidney 1554-1586
Make sure your suffering has meaning...
All suggestions/options/opinions are caveated with please consult with your local health care provider...


FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 11/18/2008 6:02 PM (GMT -7)   
Me too Navy - I had to move before I was diagnosed. Also - we are all free people. A doctor can't make us have a test. If the doctor says there is a slight chance you have something serious, I think you should have an MRI - then you can ask more questions, weigh your options, and then decide if you want to have the MRI or not. You never HAVE to have it. It is a free (not money wise but choice wise) consensual contractual relationship.
27 Year old married female law student (last year!!). Diagnosed w/ CD 4 years ago, IBS for over 10 years before that, which was probably the CD. I am sort of lactose intollerant too but can handle anything cultured and do well w/ lactose pills and lactaid. For crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn. I also have bad acid reflux and have been on PPI's since age 13. I have been through prilosec, prevacid, and nexium. Currently I am on Protonix in the morning and Zantac at night. I also take a birth control pill to allow some fun in my life.


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 11/18/2008 6:08 PM (GMT -7)   
Me too! I would rather have the option and the knowledge, rather then need it and not have it.
Forum Co-moderator - Crohn's Disease
...I will find a way, or make one. -Philip Sidney 1554-1586
Make sure your suffering has meaning...
All suggestions/options/opinions are caveated with please consult with your local health care provider...

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