Rising Healthcare Costs fuel Debate Over Evidence-Based vs. Defensive Medicine
Washington, D.C.- November 30, 2025 – A growing body of research is intensifying the long-standing tension between practicing evidence-based medicine and the prevalence of defensive medicine-ordering tests and procedures primarily to avoid potential lawsuits-as healthcare costs continue to soar. New analyses, alongside established studies, suggest that defensive practices contribute considerably to escalating expenses, perhaps impacting patient access and quality of care. The debate is gaining urgency as policymakers seek strategies to contain costs and improve outcomes, with potential implications for legal standards and clinical practice guidelines.
The core of the issue lies in the physician’s dilemma: balancing the best interests of the patient with the fear of legal repercussions. While aiming to provide optimal care,clinicians may order additional diagnostic tests or recommend specific treatments not necessarily supported by the strongest evidence,but rather as a protective measure against potential malpractice claims. This phenomenon, known as defensive medicine, is estimated to add billions to annual healthcare expenditures, diverting resources from potentially more effective interventions. The stakes are high for patients, providers, and the healthcare system as a whole, with ongoing discussions focused on refining legal frameworks and promoting a culture of transparency and shared decision-making.
Several studies illuminate the scope of the problem. research published in BMC Health Services Research (Pischedda, Marinò, & Corsi, 2023) provides a literature review examining defensive medicine through a managerial outlook, highlighting its complexities and economic consequences. Similarly, Katz (2019) in Clinical practice and cases in emergency medicine, details the history and current status of defensive medicine, exploring potential solutions to mitigate its impact.
The legal landscape also plays a crucial role. A recent article in JAMA (aaron, Robertson, King, & Sage, 2025) proposes a new legal standard for medical malpractice, potentially influencing physician behavior and reducing the incentive for excessive testing. This comes as research published in BMC Musculoskeletal Disorders (416bf50ece54) explores the impact of defensive medicine in specific specialties. Further investigation into the topic, as seen in research published in BMC Health Services Research (doi:10.1186/s13037-022-00319-8), continues to reveal the multifaceted nature of this challenge.
Moving forward, experts suggest a multi-pronged approach. This includes refining legal standards to reduce frivolous lawsuits, promoting clear communication between physicians and patients, and fostering a culture of peer review and support. Ultimately, striking a balance between protecting patients and controlling costs requires a collaborative effort from legal professionals, healthcare providers, policymakers, and researchers.
