THE USE OF LOW-OSMOLAR CONTRAST AGENTS - TECHNOLOGICAL-CHANGE AND DEFENSIVE MEDICINE

The escalating cost of medical cafe in the United States, especially i n the past decade, has resulted in efforts to identify the factors con tributing to rising costs. One factor often assumed to cause higher me dical costs is the physician's fear of liability for not using the lat est available technology. In this article, we report the results of a case study we conducted to better understand the relationship between the introduction and use of one particular technology, low-osmolar con trast agents, and liability concerns. Our study suggests that both cli nicians and administrators are primarily guided by the medical benefit s of low-osmolar contrast agents, and that liability concerns, althoug h widespread, are of secondary importance. The inability to control th is and similar technologies is likely to put a far greater strain on t he nation's health care resources than is the practice of defensive me dicine. These findings may be helpful to health policy makers, physici ans, administrators, and legislators considering choices for health ca re reform in general and for medical liability reform in particular.