The prevalence of defensive orthopaedic imaging: a prospective practice audit in Pennsylvania
"Defensive medicine is ubiquitous, but poorly understood. There has only been one previously published study of defensive practices among orthopaedic surgeons. Our study was designed to prospectively capture and analyze the current rate and cost of defensive imaging among orthopaedists in a single state.
Members of the Pennsylvania Orthopaedic Society were asked to voluntarily and anonymously record a consecutive series of patient imaging decisions (in any setting: clinic, ED, inpatient). Each orthopaedist was asked to record their demographic information and the modality, region and indication for each order. Demographics were analyzed using Chi-squared test for independence and costs were analyzed using economic models.
This is the first study to prospectively collect data on the cost and prevalence of defensive medicine in any specialty of medicine. Defensive imaging composes about 20% of all imaging orders by surveyed orthopaedists in Pennsylvania and composes 35% of the cost, indicating that defensive imaging is both common and costly."