I heard a physician on the radio the other day claiming something needed to be done about malpractice suits because “every single doctor who sees patients on a regular basis, every single day, practices defensive medicine.”
She went on to say that expensive tests are ordered when there is only a “very, very, very small chance” that something important would be found.
The malpractice attorneys should have a field day with this. Why shouldn’t patients have a test, even an expensive one, if it might find something important that would otherwise be missed? They would call doing such tests “careful medical care,” not “defensive medicine.”
As a dermatologist, I see this problem regularly with people who come in with a mole that concerns them. If there’s no chance the mole is cancer, I would never do a biopsy for medico-legal reasons. The only time I would do the biopsy is if there were a real chance of something going wrong. If there’s any chance at all the lesion could be a cancer, I would offer the test to the patient. But I would also explain that the chance of finding something is small and that if the biopsy is done, there would be a scar, other risks and costs. Patients have to evaluate whether those risks and costs are worth the potential benefit.
Recommending a test that might find something is NOT defensive medicine. It’s good practice. Educating patients about the benefits and risks, and involving them in the decisions about their care is good medicine, too.