New Survey of Physicians Paints Contradictory Picture
This week’s Archives of Internal Medicine has a survey of primary care physicians on what factors influence their own practicing habits and whether patients are getting too much or too little care.
One of the major headlines has been that 76% of primary care physicians claim malpractice concerns lead them to practice more aggressively. However, the actual survey has multiple contradictions that paint a much different picture than has been reported.
- The survey actually found that the vast majority of primary care physicians felt they were practicing the right amount of care or not aggressively enough.
- Only 28% said they were ordering more tests and referrals than they would ideally like (without indicating why they were practicing more aggressively).
- So while 76% of primary care physicians claim malpractice concerns cause them to practice more aggressively, it’s only a small subsection of these doctors that actually are practicing too aggressively.
- It has been well-documented that the current fee-for-service model of U.S. healthcare leads to overtesting.
- Yet only 3% of primary care physicians said that financial considerations influenced their own practice.
- On the other hand, 39% believed that their colleagues would order fewer tests if it were not for the fee-for-service model.
- 62% said specialists are the worst offenders when it comes to running extra tests to generate more income.
- Numerous studies have shown that physicians do a very poor job of assessing their own risk.
- In a 2010 study published in Health Affairs, researchers reported that physicians’ perceptions of liability are “not an accurate assessment of actual risk.”
- An August 2011 study in the New England Journal of Medicine found that physicians practicing in states with a lower risk of facing a claim are just as fearful of lawsuits as physicians practicing in areas with a higher risk.
- Malpractice cases are extremely rare. Only 4.4 percent of the civil caseload is comprised of tort cases, and of that subsection, just 2.8 percent comprise medical negligence cases. That number has declined by 15% over the last decade.
As many as 98,000 patients die every year from preventable medical errors, and the problem is only getting worse. It is doubtful that patients feel like they are the victims of too much care, when in fact the opposite is more likely in understaffed and overworked doctors’ offices and hospitals. Patient safety, not eliminating the legal rights of patients, should continue to be the focus.
These types of surveys have a history of becoming fodder for groups and lawmakers that want to eliminate the legal rights of injured patients as a sop to the insurance or corporate hospital industries. The unreliability of this self-reported survey shows that their talking points should be taken with a major grain of salt.