Comments on: THE HIGH COST OF DEFENSIVE MEDICINE http://www.healthcarebs.com/2008/04/23/the-high-cost-of-defensive-medicine/ Cleaning the Augean Stables of the Health Care Debate Thu, 08 Jan 2009 21:18:45 +0000 http://wordpress.org/?v=2.3.3 By: AndrewBW http://www.healthcarebs.com/2008/04/23/the-high-cost-of-defensive-medicine/#comment-159356 AndrewBW Wed, 28 May 2008 17:08:44 +0000 http://www.healthcarebs.com/2008/04/23/the-high-cost-of-defensive-medicine/#comment-159356 You're right that the NEJM study found that 40% of the cases it surveyed had no medical error. But a more detailed discussion of the study's findings would note that it found that 60% of cases had both injury and error, 37% had injury but no error, and 3% had no injury and no error. The 37% reflects the fact that, as every doctor knows, sometimes things just don't work out the way they're supposed to. But as the authors of the study themselves note: "[O]ur findings underscore how difficult it may be for plaintiffs and their attorneys to discern what has happened before the initiation of a claim and the acquisition of knowledge that comes from the investigations, consultation with experts, and sharing of information that litigation triggers." The truth is, doctors and hospitals are sometimes really lousy at disclosure. I'm willing to bet that at least some of those 37% of cases in which there was injury but no error could have been resolved by better communication and disclosure by doctors and hospitals. You can read the full NEJM study at: http://content.nejm.org/cgi/content/full/354/19/2024. You’re right that the NEJM study found that 40% of the cases it surveyed had no medical error. But a more detailed discussion of the study’s findings would note that it found that 60% of cases had both injury and error, 37% had injury but no error, and 3% had no injury and no error. The 37% reflects the fact that, as every doctor knows, sometimes things just don’t work out the way they’re supposed to. But as the authors of the study themselves note:

“[O]ur findings underscore how difficult it may be for plaintiffs and their attorneys to discern what has happened before the initiation of a claim and the acquisition of knowledge that comes from the investigations, consultation with experts, and sharing of information that litigation triggers.”

The truth is, doctors and hospitals are sometimes really lousy at disclosure. I’m willing to bet that at least some of those 37% of cases in which there was injury but no error could have been resolved by better communication and disclosure by doctors and hospitals.

You can read the full NEJM study at: http://content.nejm.org/cgi/content/full/354/19/2024.

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