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Letter to Representative Urquhart regarding Blog on Defensive Medicine |
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Written by Administrator
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Tuesday, 07 August 2007 16:56 |
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Dear Rep. Urquhart, I have received a copy of a letter or blog you wrote concerning "Medicaid--Tort Reform." I am a bit surprised that you have been taken in by the myths surrounding medical malpractice. One of the most pervasive of these myths is the "defensive medicine" myth. As a physician (an ER physician, in fact) I can tell you that one man's "defensive" medicine is another man's lifesaver. Would you be willing to be the patient of a doctor "trying to save scarce resources" by not doing some service that is known to produce a benefit? As an example, consider the PSA test (prostate specific antigen) for prostate cancer. When the test was first developed, there was a great wringing of hands and gnashing of teeth over how much money the test would cost in return for how few significant cancers it would uncover. Now, only about five years later, the annual PSA test is standard of care for every male over a certain age, and I wager that you have had more than one, knowing as you do that prostate cancer is as ubiquitous in males as breast cancer is in females. Perhaps you think it right that Medicaid recipients alone should be subject to financially based limitations on their care. I daresay you would not feel that way if your health insurance were to disappear (if for instance, you were no longer elected to the legislature and no longer received the benefit of the very generous PEHP plan afforded to legislators.) The 15% of Utahans who lack health insurance also do not feel that way. Frankly, I am surprised that a person with the intellectual capacity to obtain a law degree would fall for the anecdotal hysteria that passes for health care debate in Utah. I am sending a book to you, The Medical Malpractice Myth. It is a gift and I hope you will read at least the first chapter in its entirety. That chapter details why the problem with rising medical costs is not malpractice insurance premiums (which account for less than 1% of medical costs.) That chapter will show why the problem is the more than 100,000 deaths annually from hospital mistakes; e.g., malpractice. You will find that you have been misled by the medical industry, and you will find suggestions for policy change that make sense. Sincerely, Clark Newhall |
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Defensive Medicine is Malpractice |
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Written by Administrator
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Tuesday, 07 August 2007 16:21 |
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The medical industry coined the term defensive medicine in the early days of a propaganda offensive intended to relieve the profession of oversight by those outside the guild. Since the Middle Ages, professional guilds like medicine have sought to achieve monopoly through self-regulation, vigorously resisting any attempt to impose legal accountability. “Tort reform” is one more such attempt, and “defensive medicine” is its justification. Defensive medicine, in the words of a pre-eminent internal medicine textbook, consists of “diagnostic or therapeutic procedures that are of marginal utility to the patient” but are done to protect the physician against an imagined future malpractice claim. Without close examination, it seemed and still seems reasonable to believe that doctors, faced with the threat of malpractice suits, would do everything to ward off that threat to their financial well-being by going overboard in performing tests and procedures with marginal or no utility to the patient. After all, the doctor is the only person in the physician-patient relationship able to balance the benefit of a particular medical procedure with its potential harm to the patient. Therefore, when a doctor says the practice of “defensive medicine” makes up a large part of his practice, he is saying that in his judgment the tests, procedures or whatever is being done to the patient are being done as a talisman against the threat of a malpractice suit in this particular case. He is saying that the “defensive medicine” he practices is, in his balanced judgment, not of benefit to the patient when compared to the cost or risk to the patient. |
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