Patients may ignore "unnecessary" care

A new poll says the odds of patients following your directions are 50-50.

By Kevin B. O'Reilly, AMNews staff. Oct. 17, 2005.

More than half of U.S. adults said physicians recommend unnecessary treatments because they are worried about medical liability or want to make more money, according to a Harris Interactive poll.

Fifty-two percent of the 2,286 adults that the research firm surveyed said they chose not to comply with a physician's recommendation regarding a prescription, diagnostic test or surgical procedure because they felt it was too aggressive or unnecessary.

More than 70% of patients said they often or sometimes "experience problems" because of overly aggressive treatments, with 21% of patients saying they got a second opinion and 9% saying they found a new physician for their care.

When asked to speculate why physicians might recommend unnecessary treatments, 53% of those polled said their doctors were concerned about medical liability lawsuits, and 45% said their physicians wanted to make more money.

American Medical Association President J. Edward Hill, MD, said it's not surprising that patients believe medical liability is a driver of defensive medicine.

"Patients pretty much understand that doctors are extra cautious and order a lot of things that if they didn't have this tremendous fear of litigation they might not," said Dr. Hill, a family physician in Tupelo, Miss.

Dr. Hill said he has caught himself practicing defensive medicine and that defensive medicine has driven up medical costs tremendously.

Although a January 2004 Congressional Budget Office study of data from hospitalized Medicare patients failed to find statistically significant spending differences in states with tort reform versus states without it, many other studies have disputed the CBO's finding. For example, an article in the June 1 Journal of the American Medical Association reported that 92% of the 824 Pennsylvania physicians in six high-risk specialties surveyed said they practiced "assurance behavior" such as ordering tests, performing diagnostic procedures and referring patients for consultation when it was clinically unnecessary.