Letters Overdiagnosis

Another cause of overdiagnosis: fear of litigation

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f6969 (Published 21 November 2013) Cite this as: BMJ 2013;347:f6969
  1. Stuart John Cornell, general practitioner1
  1. 1Sheffield, UK
  1. johnc19{at}me.com

I thoroughly agree with Heath’s analysis.1 However, there is another dimension to the problem of overdiagnosis—the fear of litigation, which comes from two directions.

Firstly, I suspect that many doctors, supported by members of the public, feel there is less likely to be criticism if everything that can be done is done, even if this causes more harm than good, rather than deliberately deciding to do less.

Secondly, it is difficult for doctors to go against the perceived wisdom of the “medical profession,” as expressed in so called evidence based guidelines and advocated by leading members of the profession and the royal colleges. Even if a doctor has time to review the evidence and reach a different conclusion from that of “the profession,” there is still the worry that in the case of complaint an “expert” will be found who takes a different view.

These problems can be discussed with individual patients, who might agree that less is more, but the pervasive pressure to conform to published “standards” of practice is great. In any attempt to deal with the problem of overdiagnosis, this pressure to conform needs to be taken into account.


Cite this as: BMJ 2013;347:f6969


  • Competing interests: None declared.


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