The Harris Poll^® #22, May 8, 2002

Most Doctors Report Fear of Malpractice Liability Has Harmed Their Ability to Provide Quality Care: Caused Them to Order Unnecessary Tests, Provide Unnecessary Treatment and Make Unnecessary Referrals

Most nurses and hospital administrators confirm these adverse effects of fear of liability

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by Humphrey Taylor

An overwhelming majority of practicing physicians believes that their concerns about malpractice liability have harmed their ability to provide quality care and have caused them to order unnecessary tests and make unnecessary referrals. Almost all physicians believe that unnecessary or excessive care is provided because of the fear of liability, and this belief is corroborated by most nurses and hospital administrators. Furthermore, large majorities of doctors, nurses and hospital administrators all believe that these extra tests, referrals and procedures contribute in a significant way to health care costs.

These are some of the results of a representative, nationwide survey of 300 physicians, 100 hospital-based nurses and 100 hospital administrators, who were interviewed between March 4^th and 20^th, 2002. This research was conducted by Harris Interactive^SM for Common Good, a newly formed bipartisan coalition.

Major findings include:

Large numbers of physicians report that fear of malpractice liability causes them to provide unnecessary and inappropriate care include:
- 79% who say they order unnecessary tests;
- 74% who say they make unnecessary referrals;
- 51% who say they suggest unnecessary biopsies;
- 41% who say they prescribe unnecessary antibiotics.
Most physicians (56%) say they know other doctors who are reluctant to help an injured person off-duty because of fear of liability. And 33% know of a specific situation where a doctor did not volunteer to help.
Fully 76% of physicians report that their concerns about malpractice litigation have hurt their own ability to provide quality patient care.
Almost all physicians (94%), most nurses (66%) and hospital administrators (84%) believe that unnecessary or excessive care is sometimes (or more often) provided because of the fear of medical liability. And many physicians (38%), but fewer nurses (18%) and hospital administrators (20%) believe this happens "very often."
Almost all physicians (94%), most nurses (79%) and hospital administrators (88%) believe that the extra tests, referrals and procedures resulting from the fear of liability contribute in a significant way to health care costs.

Humphrey Taylor is the chairman of The Harris Poll^®, Harris Interactive.

TABLE 1

IMPACT OF LIABILITY CONCERNS ON TESTING, TREATMENT AND REFERRALS

"Do concerns about malpractice liability ever cause you to . . . ?"

Base: All practicing physicians

		Physicians
		Yes	No
Order more tests than you would based only on professional judgment of what is medically needed	%	79	21
Prescribe more medications such as antibiotics than you would based only on professional judgment of what is medically needed	%	41	59
Refer patients to specialists more often than you would based only on professional judgment	%	74	26
Suggest invasive procedures such as biopsies to confirm diagnoses more often than you would based solely on professional judgment	%	51	49

TABLE 2

IMPACT OF FEAR OF LIABILITY ON OFF-DUTY DOCTORS HELPING INJURED PEOPLE

"Do you have personal knowledge of . . . ?"

Base: All practicing physicians

		Physicians
		Yes	No
Physicians who hesitate or are reluctant to help an injured person when off-duty because of fear of liability	%	56	44
A situation in which a physician did not volunteer to help in such a situation	%	33	67

TABLE 3

IMPACT OF CONCERNS ABOUT MALPRACTICE ON ABILITY TO PROVIDE QUALITY CARE

"In recent years, has each of the following helped, hurt or not made a difference in your ability to provide quality patient care?"

– Concern about malpractice litigation –

Base: All practicing physicians

	%
Hurt	76
Helped	4
No difference	21

TABLE 4

UNNECESSARY/EXCESSIVE CARE PROVIDED BECAUSE OF FEAR OF LIABILITY

"Based on your experience, how often do you think unnecessary or excessive care is provided because of the fear of medical liability?"

	Physicians	Nurses	Hospital Administrators
	%	%	%
Very often	38	18	20
Sometimes	56	48	64
Rarely	5	30	13
Never	*	2	2
Not sure	-	2	1

TABLE 5

DO EXTRA TESTS, REFERRALS AND PROCEDURES INCREASE COSTS?

"Do you think such extra tests, referrals or procedures contribute in a significant way to health care costs?"

Base: Ever look for health care information online

	Physicians	Nurses	Hospital Administrators
	%	%	%
Yes	94	79	88
No	6	18	10
Not sure/refused	-	3	2

Methodology

The hospital administrators and nurses were surveyed by telephone. The physicians were surveyed online, at home or at work. The doctors’ sample was drawn from the Harris Interactive physicians’ panel.

With a sample of 300 physicians, the theoretical sampling error at the 95% confidence level is ± 6%. With the samples of 100 hospitals administrators and 100 nurses, the sampling error is ± 10%.

These statements conform to the principles of disclosure of the National Council on Public Polls.

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J15780
Q210, Q225, Q240, Q310, Q315, Q325