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Litigation fears force GPs to 'cover themselves'

IRISH doctors are ordering a plethora of expensive and unnecessary medical tests for their patients because they are afraid of being sued.

The finding comes following a survey of almost 500 Irish doctors who say that criticism of doctors in the media is one of the main motivating factors in practising 'defensive medicine' -- which is defined as doing tests and referrals when there is no medical reason to do so and covering all possible eventualities.

The news will be welcome to political parties hoping to rein in the costs of healthcare in Ireland, as it demonstrates that many unnecessary tests and scans are performed without any valid reason. In 2008 -- the latest year for which figures are available -- the HSE spent €370m on blood tests for GPs alone, which would be a fraction of the overall cost for tests.

The survey, conducted with doctors by the Medical Protection Society, a body that insures doctors against claims for negligence, found three out of four doctors practised 'defensive medicine' to avoid complaints and claims.

This would involve anything from prescribing antibiotics or other medication when there is no real need (or the doctor in question doesn't believe it will be of any use in dealing with the medical complaint), arranging another visit thought to be unnecessary, referring the patient on to another doctor or consultant, arranging for blood tests or scans when there is no medical indication they are necessary or, as one doctor put it, "the many other things that are possible in order to cover yourself".

Almost half the doctors in Ireland have been subject to either a complaint, a claim for negligence or an investigation by the Medical Council.

In the survey, 15.5 per cent were subject to a claim for negligence; just over 30 per cent had been the subject of a complaint; and 8.7 per cent had been the subject of an investigation by the Medical Council.

The good news for patients is that these claims have led doctors to keep better records.

The bad news is that almost 17 per cent of doctors say they now choose to stop treating certain conditions or perform certain procedures because they are afraid of complaints and claims.

Sunday Independent