Vast majority of physicians practice 'defensive medicine,' according to physician survey

A survey by Mount Sinai School of Medicine researchers has found that 91 percent of physicians believe concerns over malpractice lawsuits result in "defensive medicine," ordering more tests and procedures than necessary as a protective measure. The study, which questioned 2,416 physicians, is published in the June 28 edition of Archives of Internal Medicine.

A majority of physicians, 90.7 percent, also believe that better protections against unwarranted malpractice suits are needed in order to decrease the ordering of unnecessary medical tests.

"About $60 billion is spent annually on defensive medicine and many physicians feel they are vulnerable to malpractice lawsuits even when they practice competently within the standard of care," said Tara Bishop, MD, Associate, General Internal Medicine at Mount Sinai School of Medicine, and co-author of the study. "The study shows that an overwhelming majority of physicians support tort reform to decrease malpractice lawsuits and that unnecessary testing, a contributor to rising health care costs, will not decrease without it"

Dr. Bishop, Salomeh Keyhani, MD, MPH, Assistant Professor, Health Evidence and Policy, and Alex Federman, MD, MPH, Assistant Professor, General Internal Medicine, at Mount Sinai School of Medicine, conducted the national survey of physicians from a variety of practice and specialty backgrounds from June 25, 2009 to October 31, 2009.

Physicians were asked to rate their level of agreement to two statements: "Doctors order more tests and procedures than patients need to protect themselves against malpractice suits" and "Unnecessary use of diagnostic tests will not decrease without protections for physicians against unwarranted malpractice suits." Response options were on a five-point scale ranging from "strongly agree" to "strongly disagree." There were no statistically significant differences between sex, geographic location, specialty category, or type of practice.

The Mount Sinai Medical Center encompasses both The Mount Sinai Hospital and Mount Sinai School of Medicine. Established in 1968, Mount Sinai School of Medicine is one of few medical schools embedded in a hospital in the United States. It has more than 3,400 faculty in 32 departments and 15 institutes, and ranks among the top 20 medical schools both in National Institute of Health funding and by U.S. News & World Report. The school received the 2009 Spencer Foreman Award for Outstanding Community Service from the Association of American Medical Colleges.

The Mount Sinai Hospital, founded in 1852, is a 1,171-bed tertiary- and quaternary-care teaching facility and one of the nation's oldest, largest and most-respected voluntary hospitals. In 2009, U.S. News & World Report ranked The Mount Sinai Hospital among the nation's top 20 hospitals based on reputation, patient safety, and other patient-care factors. Nearly 60,000 people were treated at Mount Sinai as inpatients last year, and approximately 530,000 outpatient visits took place.

For more information, visit www.mountsinai.org.