NCPA - National Center for Policy Analysis


November 5, 2009

Many doctors feel the need to practice "defensive medicine" - the ordering extra tests, scans, consultations and even hospitalization -- to protect against malpractice lawsuits.  Doctors say the hidden costs of the tests along with malpractice insurance and lawsuit awards are major drivers behind the soaring cost of care and account for up to 10 percent of health care spending. 

The cost of annual malpractice premiums can vary wildly depending on specialty, geographic location and insurance carrier:

  • Doctors practicing internal medicine, who typically have the lowest premiums, can pay as little at $3,375 in Minnesota and as much as $57,859 in Florida.
  • Obstetricians and gynecologists, who typically have the highest premiums, can spend as much as $201,808 in Florida and as little as $20,626 in Minnesota, according to the Medical Liability Monitor, which tracks premium costs.

Doctors say defensive medicine can also produce a snowball effect, with one unnecessary test leading to more unnecessary tests:

  • More than 80 percent of the nearly 900 doctors who responded to a 2008 survey by the Massachusetts Medical Society reported practicing defensive medicine.
  • The group estimated the cost of the extra tests at $281 million and the cost of unnecessary hospital admissions at $1.1 billion.
  • A 2005 study of 824 doctors in Pennsylvania by researchers at the Harvard School of Public Health and Columbia Law School found 93 percent reported practicing defensive medicine.

Source: Steve LeBlanc, "Health Care Dispute: Costs of Defensive Medicine." Associated Press, November 4, 2009.


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