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Justinian Lane

How many lives has “defensive medicine” saved?

“Defensive medicine” is the name given to tests that doctors run more out of fear of being sued than out of concern for their patients.  The poster-child of the “defensive medicine” argument is the CT scan.  We’re told by “reformers” that these tests are expensive and unnecessary.  (The “reform” crowd doesn’t tell us that many doctors have a financial interest in the facilities that own CT scan machines, meaning the more tests the doctors order, the more money they make.  But that’s for another day.)  Here’s some interesting food for thought about whether the tests are truly unnecessary:

WASHINGTON — Annual CT scans of current and former heavy smokers reduced their risk of death from lung cancer by 20 percent, a huge government-financed study has found. Even more surprising, the scans seem to reduce the risks of death from other causes as well, suggesting that the scans could be catching other illnesses.

The findings represent an enormous advance in cancer detection that could potentially save thousands of lives annually, although at considerable expense. Lung cancer will claim about 157,000 lives this year, more than the deaths from colorectal, breast, pancreatic and prostate cancers combined. Most patients discover their disease too late for treatment, and 85 percent die from it.

* * * *

The study found that for every 300 people who were screened, one person lived who would otherwise have died during the study. But one-quarter of those given CT scans were found to have anomalies, nearly all of which were benign. These false signals generally led to more worry, more CT scans and sometimes to lung biopsies and thoracic surgery.

Source: Lung Cancer Deaths Reduced by CT Scans, Study Finds - NYTimes.com

If 1 out of 300 lives were saved in this study, it’s reasonable to assume that at least some lives are saved when “unnecessary” CT scans are run.  I’m still waiting for a survey or study to determine how many doctors changed their diagnosis based upon a test they felt was unnecessary but ordered merely to play CYA.

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Posted at 12:41 PM, Nov 05, 2010 in Medical Malpractice
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Comments

While CT scan is a great helper in examination of patients. I know a case where a patient is wrongly treated for another disease due to a broken machine. Not getting unnecessary CT scan hurts on your pocket but getting a wrong scan is worse.

Posted by: lpn to rn | November 6, 2010 1:48 AM

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Posted by: Emily | November 6, 2010 1:55 AM