CHICAGO–Despite a wide perception that radiologists should make and record recommendations for additional testing to avoid malpractice, the data indicate that outside of breast radiology, failure to recommend an additional test as a primary allegation is very rare, according to Kim S. Clarkin, MD, of New Jersey Medical School in Newark, during a session on Nov. 28 at the 97th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA).

Clarkin and colleagues asked and answered the question “Is failure to recommend an additional test a major cause of malpractice for radiologists,” in an analysis of a survey of 8,401 radiologists participating in the network of One Call Medical, a broker for CT/MR studies in workmen’s compensation cases.

Among the radiologists surveyed, there were 4,073 malpractice claims. Of all the claims, 1.2 percent alleged failure of a radiologist to recommend an additional test or procedure. In 6 of these, the test in question did not involve imaging. Of the other 45 cases, 18 concerned breast disease. The remaining 27 were non-breast cases, encompassing 0.6 percent of overall malpractice claims for which the most common modality alleged to have not been recommended was CT.

Clarkin et al concluded, “The failure to recommend an additional test by a radiologist is a rare source of malpractice claims. The notion that radiologist must practice defensive ordering is [incorrect].”