A national survey published in the September issue of Archives of Internal Medicine revealed that 42 percent of primary care physicians feel pressured to provide excessive testing and referral care. The reasons? According to Medpagetoday.com:
- 76 percent are concerned about malpractice lawsuits
- 52 percent cite growing reliance on clinical performance measures
- 40 percent have insufficient time with patients
Conducted by Dr. Brenda E. Sirovich and her colleagues from the Veterans Affairs Outcomes Group in White River Junction, Vermont, the survey targeted 627 family physicians and internists, most of whom were male and in practice for 25 years.
Malpractice fears headed the list of doctors’ concerns, prompting them to provide more aggressive or defensive medicine than they would otherwise. A full 83 percent believed that omitting a test for a given clinical situation would put them at risk for a medical malpractice lawsuit. On the other hand, just over 20 percent believed that ordering unnecessary tests posed the same risks.
While 45 percent believed one in ten patients could be effectively handled with a simple phone call, email, or treatment from a nurse or other health professional, 61 percent believed that sub-specialists physicians devoted to a narrow spectrum of care, such as geriatric medicine, gastroenterology or medical oncology practiced more aggressively than primary care physicians and 47 percent indicated that physician assistants and nurse practitioners also practiced more defensive medicine.
New Care Approach is Required to Dispel Physician Concerns
As debate rages over the future of healthcare with one extreme fearful of healthcare rationing and the concerned about unsustainable spending the voices of primary care physicians have been largely ignored, according to survey news coverage on ABCnews.go.com. Yet, according to researchers, the primary care doctor is the pivotal figure in a patient’s care and the one who exercises the most direct control.
“There needs to be a fundamental realignment of financial incentives and reform of the malpractice system,” the authors said in Medpagetoday.com. “Physicians believe they are paid to do more and exposed to legal punishment if they do less.”