AAOS: Defensive Medicine Prevalent in Orthopedics

National costs estimated at $2 billion annually for orthopedic surgery

THURSDAY, Feb. 9 (HealthDay News) -- Almost all orthopedic surgeons report practicing defensive medicine, with costs per surgeon estimated at $100,000 per year, according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons, held from Feb. 7 to 11 in San Francisco.

Manish K. Sethi, M.D., from the Vanderbilt University Medical Center in Nashville, Tenn., and colleagues investigated the financial implications of defensive medicine by contacting 2,000 randomly selected orthopedic surgeons in the United States. Of this group, 1,214 orthopedic surgeons (61 percent) completed a Web-based survey. Cost analysis was carried out using Centers for Medicare & Medicaid Services data, which were aggregated to reflect the eight domains of care evaluated in the study.

The researchers found that 96 percent of the respondents reported having practiced defensive medicine, mainly to avoid potential malpractice liability. On average, 24 percent of tests were ordered for defensive reasons (ranging from 18 percent of biopsies to 44 percent of ultrasounds), and defensive hospital admissions averaged 7 percent per month. The cost of defensive medicine per respondent was estimated at $8,500 per month or $100,000 per year. The national cost of defensive medicine for orthopedic surgery was estimated to be $173 million per month and $2 billion per year.

"Defensive medicine among orthopedic surgeons is a significant factor in health care costs and of marginal benefit to patients. Policies aimed at managing liability risk may be useful in containing such practices," the authors write.

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