The doctor-owned laboratories performed almost twice as many tests for each patient as other laboratories, at an average cost of $43 per patient compared with $20. Doctor-owned physical therapy centers typically scheduled more visits per patient but employed fewer licensed therapists.
HEADLINERS - When Doctors Own Their Own Labs - NYTimes.com
HCA, the largest for-profit hospital chain in the United States with 163 facilities, had uncovered evidence as far back as 2002 and as recently as late 2010 showing that some cardiologists at several of its hospitals in Florida were unable to justify many of the procedures they were performing. Those hospitals included the Cedars Medical Center in Miami, which the company no longer owns, and the Regional Medical Center Bayonet Point. In some cases, the doctors made misleading statements in medical records that made it appear the procedures were necessary, according to internal reports.
http://www.nytimes.com/2012/08/07/b...dubious-cardiac-work.html?pagewanted=all&_r=0
The Congressional Budget Office has called the evidence of defensive medicine “not conclusive,” and summarized, “On the basis of existing studies and its own research, CBO believes that savings from reducing defensive medicine would be very small.”i Researchers at Dartmouth College echoed these conclusions, saying, “The fact that we see very little evidence of widespread physician exodus or dramatic increases in the use of defensive medicine in response to increases in state malpractice premiums places the more dire predictions of malpractice alarmists in doubt.”ii
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The GAO has also found that doctors may actually practice “defensively” because it generates more income. They identified “revenue-enhancing motives” as one of the real reasons behind the utilization of extra diagnostic tests and procedures.vi In Florida, health authorities determined diagnostic-imaging centers and clinical labs were ordering additional tests because the majority were physician-owned and the tests provided a lucrative stream of income. Federal law now prohibits the referral of Medicare patients to certain physician-owned facilities, many of which charge double the amount in lab fees.vii As Mello and colleagues commented, “In medicine practiced as a business, defensive medicine is understood and may even be profitable.”viii
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ANd this is with laws in place to limit such things. It was even a larger problem in the past.
