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Defensive Medicine and Medical Malpractice

The purpose of this document is to provide hospitals and the Joint Commission on Accreditation of Hospitals Organization (JCAHO) a guide prepared by medical physicists recommending tests and proce- dures for medical lasers to maintain a high level of quality care in a safe environment. The guidance for safe use of laser systems for diagnosis and therapy is intended for use by all health care personnel associated with laser systems’ operation (physicians, nurses, medical physicists), maintenance (engineers), and service (biomedical technicians). The suggested controls are based upon evaluation of potential hazards from laser radiation; unique problems related to operating rooms, outpatient clinics, and private medical offices; and exposure risks to. | Defensive Medicine and Medical Malpractice July 1994 OTA-H-602 NTIS order PB94-193257 GPO stock 052-003-01377-1 Eefensive Medicine and Medical Malpractice Office 0Í TfCHNOtOGY AMfUMINI CỡNũUĩâ Of IMt UNfffD Swti Recommended Citation U.S. Congress Office of Technology Assessment Defensive Medicine and Medical Malpractice OTA-H--6O2 Washington DC U.S. Government Printing Office July 1994 . oreword The medical malpractice system has frequently been cited as a contributor to increasing health care costs and has been targeted in many health care reform proposals as a potential source of savings. The medical malpractice system can add to the costs of health care directly through increases in malpractice insurance premiums which may be passed on to consumers and third-party payers in the form of higher fees. However total direct costs of the medical malpractice system represent less than 1 percent of overall health care costs in the United States. The medical malpractice system may also increase costs indirectly by encouraging physicians to practice defensive medicine. In this assessment the Office of Technology Assessment first examines the nature of defensive medicine adopting a working definition of defensive medicine that embraces the complexity of the problem from both the physician and broader public policy perspectives. It then presents and critically examines existing as well as new evidence on the extent of defensive medicine. Finally it comments on the potential impact of a variety of medical malpractice reforms on the practice of defensive medicine. This assessment was prepared in response to a request by the House Committee on Ways and Means and the Senate Committee on Labor and Human Resources. The report was prepared by OTA staff but OTA gratefully acknowledges the contributions of the assessment advisory panel numerous researchers who did work under contract to OTA and many other individuals who provided valuable information and reviewed preliminary drafts.