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Majority of ER Doctors Admit Ordering Tests Defensively

97 percent said they had patients undergo procedures that weren’t medically needed

TUESDAY, March 24, 2015 (HealthDay News) — Nearly all emergency department doctors recently surveyed said they order magnetic resonance imaging or computed tomography scans their patients may not need, mainly because they fear malpractice lawsuits. These findings were published online March 23 in Academic Emergency Medicine.

Of 435 emergency department physicians who completed the survey, 97 percent admitted to ordering some advanced imaging scans that weren’t medically necessary, the findings showed. Such scans contribute to the estimated $210 billion wasted annually on unnecessary tests, procedures, and treatments, the researchers contended.

Physicians said they ordered too many imaging tests because they are worried about missing an unlikely — but possible — illness, and fear being sued if they don’t cover all their bases, the results of the survey revealed. The emergency department physicians surveyed also suspect they aren’t the only staff doing this. More than 85 percent believe too many diagnostic tests are ordered in their own emergency departments, by themselves and others.

“We don’t like uncertainty, and so we’re driven by this culture that says if there’s any doubt, we should do the test, and we don’t acknowledge the potential harms of this approach,” lead author Hemal Kanzaria, M.D., an emergency physician at the University of California in Los Angeles, told HealthDay. “I would encourage patients to ask their physicians what the chance of them having the disease that’s getting worked up is,” Kanzaria said. “Ask if the tests are needed. I would also encourage patients to think about both the potential benefits and the potential harms.”

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