Defensive medicine

defensive medicine

n.

Diagnostic or therapeutic measures conducted primarily as a safeguard against possible malpractice liability.

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defensive medicine

A style of Pt management defined as those '…objective measures taken to document clinical judgement in case there is a lawsuit–costing ± $7 billion/yr US…'; DM is designed to minimize lawsuits and includes such 'devices' as

Defensive medicine

Informed consent A document to indicate Ps understanding of the intended outcome and potential risks of a procedure

Documentation Formal paperwork generated by a physician that justifies his reasoning for managing a Pt, which may be viewed as being'unreasonably excessive'

Medical workup Over-ordering of diagnostic tests to rule out 'zebras'–unusual diseases that are not seriously considered as diagnoses, which may rarely be seen in similar circumstances–a form of highly prevalent CYA–cover your ass mentality

DM is virtually a standard of practice in the US; its financial impact is difficult to quantify, and is to ± ↑ the cost of US health care by 20-40% Note: The disadvantage of providing a list of potential complications–each of which may be extremely rare may overwhelm the Pt, causing him to forego a needed procedure, resulting in 'misinformed consent' This highly colloquial and vulgar abbreviation is commonly used at all levels of medical practice and training, and has appeared in at least one major medical journal; 'CYA', ie diagnostic 'overkill', has a mystical overtone, as the physician may be advised to 'CYA' to ward off the evil humors of litigation; DM is practiced by ± 84% of US physicians, in order to protect themselves from potential malpractice-related lawsuits AMN 25/5/92 p3 in the US, anything less than a perfect outcome is unacceptable to a consumer, for whom the threshold for litigation appears to ↓ as medical technology ↑, despite the known risks for certain procedures