Is Defensive Mechanism an escape from duty?

Many times, a surgeon has to make tough decisions during surgeries. MIT economist pulled the curtain of the medical professionals that whether at the time of operation, they make decisions to run from legal entanglements or perform their duty.

The Massachusetts Institute of Technology researchers, find out what drives doctors to conclude performing Caesarean’s instead of normal deliveries. When a child’s birth is concerned, many doctors safeguard themselves by opting cesarean to avoid the potential problems during delivery.

The research studied the U.S. Military Health System data, and the results showed that when a doctor is free from legal suits, they perform more than C-section operations as compared when they have legal bindings. Jonathan Gruber, an economist from MIT, says, “When you’re worried about errors of commission, defensive medicine can lead to the [less] treatment of patients.”

The paper published in the Journal of Empirical Legal Studies called ‘Defensive Medicine and Obstetric Practices: Evidence from the Military Health System’ authored by Jonathan Gruber and Michael Frakes, a professor of law and economics from  Duke University School of law.

A natural experiment performed by Gruber and Frake using data from the Military Health System from the year 2003 to 2013, in which the births counted 10,16,606, amongst which 44% were at military health facilities and the remaining 56% were in civilian hospitals. The doctors are afraid of getting sued in military hospitals and they perform C section 4% more as compared to the civilian doctors. These authors have published a paper earlier as well on the same topic with different findings. But Gruber says, “This [new] paper is sort of the flip side of the first paper.” However, in this paper the findings are doctors act reasonably and optimally, the paycheque of performing C sections is more than other operations. The defensive mechanism urges the doctor to take more tests to prevent themselves from potential lawsuits. Overall, there is a balance maintained by doctors and the author says that defensive mechanism has two sides- positive and negative to play.