Defensive Medicine

This article appears in the April 2012 issue of HealthLeaders magazine.

Our annual Industry Survey shows that 8% of healthcare leaders count malpractice insurance and litigation among their organization's top three drivers of healthcare costs. And 58% of physician leaders say they have, in the past year, ordered a test or procedure for primarily defensive medicine reasons. How serious is this issue and what can healthcare leaders do about it?    

Alan Fisher, MBA, FACHE
CEO, Advanced Specialty Hospitals of Toledo, OH
Defensive medicine remains a very serious issue, but our focus can't be on practicing defensive medicine. We need to be proactive in looking at what can be done from a quality standpoint first. If we practice good-quality healthcare, that should minimize the unnecessary and sentinel events.

At our hospital, we do a thorough examination of our benchmarks and look at those items that can be prevented. For example, if we have issues of back transfers, because we are a long-term acute care hospital, it begs the question: What could we have done proactively to avoid this? In the past couple of years, more specifically within the past 12 months, we have seen an increase in quality by being more proactive in our practices, resulting in a decrease in practicing defensive medicine.

We can practice defensive medicine all we want to, but if it is for the wrong reasons—and that is not to provide good outcomes for patients—then we are hurting both patients and ourselves.