HealthDay News — The more tests and treatments U.S. doctors order for patients, the less likely they are to be sued for malpractice, according to a study published online Nov. 4 in The BMJ.

Researchers looked at data from nearly 19 million Florida hospital admissions between 2000 and 2009 and malpractice claims against 24 637 doctors in seven specialties. There were 4342 malpractice claims. The overall rate was 2.8% per doctor annually, ranging from 1.6% per doctor a year in pediatrics to 4.1% per doctor a year in general surgery and obstetrics and gynecology.

Across all seven medical specialties in the study, higher average spending was associated with a lower risk of malpractice claims, the researchers found. For example, risk of a malpractice claim against internal medicine specialists ranged from 1.5% among those in the bottom fifth of patient spending ($19 725 per hospital admission) to 0.3% among those in the top fifth of spending ($39 379 per hospital admission).

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“The study shows that we need to better understand defensive medicine and how this type of practice impacts both patients and physicians,” write the authors of an accompanying editorial.


Jena AB, Schoemaker L, Bhattacharya J, et al. Physician spending and subsequent risk of malpractice claims: observational study. BMJ. 2015; doi:351:h5516.

Bishop TF, Pesko M. Does defensive medicine protect doctors against malpractice claims? BMJ. 2015; doi:351:h5786.