Physicians prefer stress tests to angiography in states with malpractice caps

Physicians practicing in states that implemented damage caps for malpractice claims were 24 percent less likely to use angiography as an initial diagnostic test and 7.8 percent more likely to use noninvasive stress testing, according to a Cardiovascular Business report.

Steven A. Farmer, MD and PhD, with George Washington University, led the JAMA Cardiology study that examined the behavior of 36,647 physicians in nine states that imposed malpractice damage caps, comparing their willingness to perform tests and interventions for coronary artery disease to more than 39,000 clinicians in states without such caps.

Those in capped states were 21 percent less likely to order a subsequent angiography after stress testing and were 23 percent less likely to perform revascularization.

“A core issue for these models is provider resistance to changing established practice patterns,” wrote Steven A. Farmer, MD, PhD with George Washington University and colleagues. “Our study suggests that physicians who face lower malpractice risk may be less concerned with that risk, and thus more receptive to new care delivery strategies associated with alternate payment models.”

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