Albert Francis E. Domingo, MD

my flight of ideas


Posted on | June 3, 2006 | No Comments

(Part 6 of Stateside Healthcare: Art, Science, and Commerce?)

While the Filipino patient’s legal rights may be similar or have equivalents to his/her US counterpart, there still are medical issues bordering with law that should be explored, and the most prominent of this (with a great effect on how US physicians practice) is medical malpractice.

Given the available knowledge and skills of practitioners, with patients highly aware of their disease and probably its management, the constant apprehension on being sued for medical malpractice has physicians practicing defensive medicine. A common example is a patient with abdominal pain which, given a thorough history and physical examination, could be easily diagnosed as having appendicitis. While the impression of appendicitis might as well be written down by the keen physician, he/she would probably order imaging studies all the same in order to “properly document” the case for future reference. It would not be surprising that some US physicians would proceed to order CT imaging of the abdomen for what could as well be a straightforward surgical problem.

This defensive behavior has led to a higher cost of healthcare in comparison with the Philippines’ own, with defensive medicine estimated to account for up to 20% of medical costs (total medical costs in 1995 were estimated to be at US$ 900B) . Several diagnostics are ordered with the intention of preparing in advance for the possibility of being sued.

Next: Health as Wealth: Managed Care

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