In his blog on patient protection, malpractice attorney Patrick Malone questions the idea of “defensive medicine.” He writes, “if there’s any chance the test may help the patient by revealing a treatable problem, then the test was necessary and doesn’t fall into the category of insurance fraud or defensive medicine.”
This isn’t quite true. Every test also comes with risks. A test might have a chance of revealing a treatable problem, but the risk of the test might exceed the potential benefit. For example, we could get a chest X-ray to look for cancer or a CAT scan of the head to look for brain injury, but the risk of the radiation may well exceed the potential benefit of the test. The right answer in such situations may be to avoid the test. But if a doctor doesn’t order the test, he or she runs the risk of missing the rare treatable problem and being sued.
The right answer to this may lie in a less paternalistic medical system. The doctor ought to educate the patient about the benefits and risk of the test, then let the patient decide if they want to take the risk of the test or the risk of missing the rare problem. Empowering the patient is usually the right answer, whether it comes to health care costs or avoiding malpractice issues.