Do Doctors Prescribe Antibiotics Out of Fear of Malpractice?

Abstract

This paper investigates whether doctors prescribe antibiotics to protect themselves against potential malpractice claims. Using data from the National Ambulatory Medical Care Survey on more than half a million outpatient visits between 1993 and 2011, I find that doctors are 6% less likely to prescribe antibiotics after the introduction of a cap on noneconomic damages. Over 140 million discharge records from the Nationwide Inpatient Sample do not reveal a corresponding change in hospital stays for conditions that can potentially be avoided through antibiotic use in the outpatient setting. These findings, as well as a stylized model of antibiotic prescribing under the threat of malpractice, suggest that liability-reducing tort reforms can decrease the amount of antibiotics that are inappropriately prescribed for defensive reasons.

What is the optimal strategy for managing primary care patients with an uncomplicated acute sore throat? Comparing the consequences of nine different strategies using a compilation of previous studies

“… 25 32 56–61 Some practitioners prescribe antibiotics to all, or nearly all, patients with a sore throat, perhaps in an attempt to reduce risks, to meet patient expectations or to reduce risks of litigation. 62 However, the art of medicine is rarely about achieving zero risk but rather to weigh different risks and benefits.…”

“…While guidelines are important in theory and likely to have some impact,55 some practitioners seem to develop their own individual approach to manage patients presenting with a sore throat that differs significantly from any guideline 25 32 56–61. Some practitioners prescribe antibiotics to all, or nearly all, patients with a sore throat, perhaps in an attempt to reduce risks, to meet patient expectations or to reduce risks of litigation 62. However, the art of medicine is rarely about achieving zero risk but rather to weigh different risks and benefits.…”