I will not pretend I have all of the answers. I will leave that to folks who are smarter than I am. I do know that just the threat of getting sued plays a huge role in how physicians conduct themselves on a day to day basis. With today's medicolegal climate, when I go to work and see a fairly routine patient with a fairly routine complaint, I am much more inclined to order a $10,000 work-up to get a 99% diagnosis, than to spend $200 to get a 97% diagnosis. Knowing that there are dozens of malpractice attorneys around the corner salivating to get their hands on me. Knowing full well, that although I may be innocent of any wrong doing, I may be tied up in court for years and that a judgement may be settled out of court because it is cheaper than actually defending myself. This is 'lawsuit lotto', and the attorneys know this. They will tell you that they are protecting patient's rights, yet take 60% or more of any award. Make no mistake, I agree with compensating a person who is a victim of gross negligence, however, the trial lawyers have the current system rigged and flood Congress with money to keep it that way.
Shine it up any way you want, but it still stinks.

Mr. Bryant,
Thank you for your response. I may have been a little loose with my figures. I really did not expect a response. I can tell you there is real fear in the medical community. I see all types of people. Often with very little information and very limited time to take a detailed history and physical. Many of these patients often have a variety of vague and diffuse complaints involving different organ systems and anatomic regions. For instance, somebody walks into clinic off of the street complaining of acute back pain, and on review notes a little neck pain, and some non-specific chest pains and an occasional headache. Now I may suspect a lower back sprain, order L-Spine films and send the patient home with ibuprophen and orders to take it easy for several days. But there is real pressure to order all of the labs, blood work and expensive imaging to cover all of the bases. Knowing full well that the probability of finding something is slim. Yet, god forbid, I miss that rare malignancy, anyeursm or active coronary artery disease. Now imagine that all of that additional cost multiplied by the 20-30 patients per day.