Taking responsibility for our actions is the key to changing a person or a system.  In the health care system, we all should be focused on ways to make the system safe.

Any time you mention health care costs the issue becomes political. The focus is never patient safety. In my role as a medical malpractice attorney, every day I speak to injured patients and their loved ones whose lives are forever changed due to the unsafe medical care they received.  Ordering unnecessary diagnostic tests is claimed to add billions of dollars to health care costs in this country. “Defensive medicine” is the coined term used. A recent letter to the American Heart Association from S. Clark Newhall, MD, JD, highlights the hypocrisy of the medical and insurance industry’s refusal to take responsibility for their own actions:

“To the Editor:

The article “Variation in Cardiologists’ Propensity to Test and Treat: Is It Associated With Regional Variation in Utilization?” raises an interesting question: do the cardiologists who admit to “ordering a potentially unnecessary cardiac catheterization” discuss this issue with their patients? Do these cardiologists inform those patient that the procedure is potentially unnecessary, expensive and potentially life threatening? Do these physicians discuss the risk-benefit issue with their patients and advise the patient that the risk of the “potentially unnecessary cardiac catheterization” outweighs the benefit? Do these physicians then perform the test despite their judgment that it is potentially unnecessary? If so, I submit that these physicians are performing below the standard of care as they define it for themselves, and therefore are committing self-admitted malpractice.

My guess is that these same physicians, asked by a surveyor if they were engaging in “defensive medicine” would answer affirmatively, whereas if the patient asked the same question of the same physician, the answer would be “certainly not–the procedure is for your benefit, not mine.”

The symbol of our profession is Hippocrates, not hypocrisy.”

When your doctor orders a test, you have a right to know the reasons for the test and the known risks and benefits. Crying “defensive medicine”  is a way to divert our attention from the serious crisis of unsafe medical care and its catastrophic consequences.