[Effects of defensive medicine on costs].

Physicians who give priority to the reduction of their exposure to malpractice as compared to the health of their patients practise defensive medicine. Far-reaching yieldingness to unjustified requests of the patients in order to avoid unpleasant quarrels also falls into this category. Among other things, an increase in diagnostics, consultations and in-patient treatments as well as a decrease in risky medical measures are the consequences. Investigations performed mainly in the U.S.A. and to a minor degree also in Holland and the U.K.--but none in Germany--have clearly shown that global medical costs can considerably be forced up by defensive thinking and acting of the physicians. As an example, the increase in the rate of Caesarean sections based on defensive reasoning is discussed. The defensive way of acting in daily medicine is predominantly a response to stringent jurisdiction often obviously favouring the patient's claims. Thus, indirectly the respective judges also bear responsibility for the explosion of medical costs!