Study: Lawsuit fears, peer pressure drives higher costs, more tests

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Apr 15 2010

The Associated Press: A quarter of heart doctors order more tests than were necessary, driving up costs, according to a new study. "Most said they weren't swayed by such things as financial gain or a patient's expectations. But about 24 percent of the doctors said they had recommended the test in the previous year because they were worried about malpractice lawsuits. About 27 percent said they did it because they thought their colleagues would do the test. Doctors who treated their patients aggressively were more likely to be influenced by malpractice worries or peer pressure than those who weren't as aggressive, the study determined" Researchers used Medicare records to score doctors on tests and treatments for three hypothetical heart patients. The study appeared in the journal Circulation: Cardiovascular Quality and Outcomes (Nano, 4/13).

The Wall Street Journal Health Blog: "During the health-care debate, the impact of medical malpractice suits was controversial, with the Republicans saying it was a key part of the escalating cost issue and the Democrats saying, not so much. For its part, the CBO estimated tort-law changes would cut only about 0.5% from U.S. health-care spending. … The researchers surveyed 598 cardiologists across the U.S. about what non-clinical reasons might lead them to recommend cardiac catheterization. They also calculated a doctor's 'cardiac intensity score' — a quantitative measure of his or her propensity to test and treat, based on his or her response to hypothetical patient scenarios" (Hobson, 4/13).

ABC News has a video story on the study. "The survey also showed peer pressure was significant....Practices vary widely across the country" (4/13).

This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.