Defensive medicine is a reaction to the rising costs of malpractice insurance premiums and patients’ biases on suing for missed or delayed diagnosis or treatment but not for being overdiagnosed.
Physicians order tests and avoid treating high-risk patients (when they have a choice) to reduce their exposure to lawsuits, or are forced to discontinue practicing because of overly high insurance premiums.
In India, a rise of physical attacks on practitioners and lack of support from public and government systems are the prime reasons for defensive medicine.
Assurance behavior involves the charging of additional, unnecessary services to a) reduce adverse outcomes, b) deter patients from filing medical malpractice claims, or c) preempt any future legal action by documenting that the practitioner is practicing according to the standard of care.
[6] In a study with 824 US surgeons, obstetricians, and other specialists at high risk of litigation, 93% reported practicing defensive medicine, such as ordering unnecessary CT scans, biopsies, and MRIs, and prescribing more antibiotics than medically indicated.
[8] Defensive medical decision making has spread to many areas of clinical medicine and is seen as a major factor in the increase in health care costs, estimated at tens of billions of dollars annually in the US.