Unnecessary Costs

Healthcare systems should develop clinical practice guidelines to evaluate their procedures, such as imaging or MRIs, Sethi says.

The researchers tallied potential defensive medicine procedures, such as imaging, that physicians often use but shouldn't. Specifically, the cost of defensive medicine averages about $101,820 per orthopedic surgeon per year, the study shows. When that figure is multiplied by 20,400—the average number of orthopedic surgeons practicing in the United States—the average cost per year for defensive medicine procedures totals more than $2 billion, Sethi says.

The researchers published their findings in the February issue of the American Journal of Orthopedics, which include a national survey of 2,000 orthopedic surgeons selected randomly through a list provided by the American Academy of Orthopaedic Surgeons.

"There are standards of practice that are evidence-based, in which physicians develop recommendations of what can work," Sethi says. "If a physician follows these recommendations, there can be greater efficiency and physicians should be protected against liability if they follow clinical practice guidelines. Say, for instance, if someone has a knee pain, a physician should adhere to the guidelines and maybe not perform an MRI right off the bat. Physicians need to take control of the future of medicine and escalating costs, but there is a long way to go."

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