4 key notes on defensive medicine for spine-focused neurosurgeons — premiums reach $104k


A new study published in Spine examines defensive medicine among spine and neurospine surgeons in the United States.

The study authors sent an online survey to 3,344 members of the American Board of Neurological Surgeons and received a 30.6 percent response rate; 499 neurosurgeons performing mainly spine procedures responded. There were eight questions on the survey.


The average survey respondents had been in practice 16.6 years and reported a lifetime case volume of 4,767. The researchers found:


1. Annual malpractice premiums for neurosurgeons were $104,480 on average, which was similar to the rate for nonspine neurosurgeons.


2. The spine neurosurgeons reported a higher rate of ordering labs, medications, referrals, procedures and imaging solely for liability concerns — 89.2 percent — than their non-spine neurosurgeon counterparts — 84.6 percent.


3. The neurosurgeons who performed primarily spine cases were three time more likely to practice defensive medicine compared to their non-spine counterparts. The researchers reported the same results when controlling for high risk, annual malpractice premiums, percentage of patients publicly insured, malpractice claims over the past three years and state medical-level environments.


4. The researchers concluded, "State-based medical legal environment is not a significant driver of increased defensive medicine associated with neurosurgical spine procedures."


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