Intended for healthcare professionals


Does defensive medicine protect doctors against malpractice claims?

BMJ 2015; 351 doi: (Published 04 November 2015) Cite this as: BMJ 2015;351:h5786

Re: Does defensive medicine protect doctors against malpractice claims?

The NHS litigation authority in their annual review reported an 18% increase in clinical negligence claims from 2013 to 2014 costing a total of £1.19 billion. This trend has been increasing year on year and shows no signs of slowing. If the article published were true then defensive medicine should theoretically reduce the number of claims and ultimately clinical negligence expenditure. If this were the case why are not all hospitals encouraging defensive medicine?

Referrals, tests and all forms of investigations cost money. These investigations can be extremely inconvenient for patients and expose them to unnecessary risk. The cost of defensive medicine is impossible to calculate as physicians will justify their requests on clinical grounds. As the number of claims relative to patient encounters is very small it is reasonable to assume that defensive medicine spending would easily outweigh clinical negligence expenditure.

The article highlights a potential link between increased spending and reduced negligence claims it fails however to assess the level of harm unnecessary investigations can place on patients, nor does it mention the impact it has on waiting times for those who genuinely need to be investigated.

We believe that hospitals should implement stricter criteria for blood tests and imaging to deter unnecessary investigations. Greater emphasis needs to be placed on communication and documentation which although time consuming are a safer and more economically viable solution in the growing trend of medical litigation, particularly in publicly funded services like the National Health Service.

Competing interests: No competing interests

25 November 2015
Huw A Griffiths
Debashish Dutta, Ganapathyagraharam Sridharan
The Princess Alexandra Hospital, Hamstel Road, Harlow, Essex, CM20 1QX