Nearly 600 doctors were surveyed for the study to determine how aggressively they treat their patients and whether non-medical issues have influenced their decisions to order invasive heart tests.

Most said they weren’t swayed by such things as financial gain or a patient’s expectations. But about 24 percent of the doctors said they had recommended the test in the previous year because they were worried about malpractice lawsuits. About 27 percent said they did it because they thought their colleagues would do the test.

Doctors who treated their patients aggressively were more likely to be influenced by malpractice worries or peer pressure than those who weren’t as aggressive, the study determined.

The research was done to see whether doctors’ attitudes and practices might be contributing to the wide differences in health care use and spending across the country.

“We have known for a long time that where you live has an influence on what kind of health care you get and how much health care you get,” said Lee Lucas, lead author of the study and associate director of the Center for Outcomes Research and Evaluation at Maine Medical Center in Portland.

Some of the reasons are known: differences in disease rates, patient preferences and the availability of medical services or hospital beds. And more care isn’t necessarily better care, Lucas noted.

For the study, the doctors were asked to recommend tests and treatment for three hypothetical heart patients. Their answers were used to score them on how aggressively they tend to treat patients.

Using Medicare records, the researchers found that doctors with higher scores were more likely to be in the areas with higher spending overall or higher rates for a heart test, although the differences were small.

The doctors were also asked whether other issues had led them to recommend the heart test — called a cardiac catheterization — during which a thin tube is threaded to the heart to check how well it is working and to look for disease.

The researchers suggest that targeting malpractice concerns could help reduce the regional differences.

“We need a way for docs to be less afraid of not ordering a test,” said Lucas.

Medical malpractice was part of the health care reform debate, but didn’t make it into the recently approved legislation. The new law does include pilot programs for states to explore alternatives to lawsuits.

The study was released Tuesday by the journal Circulation: Cardiovascular Quality and Outcomes.

The results support moving toward more integrated health care, and away from fee-for-service payments, and working on malpractice reforms, said Kenneth Thorpe, a professor of health policy at Emory University in Atlanta.

Lucas said patients can help by not pressuring their doctors to do tests.

“If he says you don’t need it, let it go,” she said.

McDuffie has been awarded $11.5 million in a lawsuit against his former doctor over his career-ending toe injury, according to the Associated Press. The doctor, John Uribe, used to work for the Dolphins as a team doctor. He called the damage award a travesty and will most likely appeal the decision.

The attorney for McDuffie told the news source that the award is fair compensation for his client’s lost earnings.

The lawsuit stems from the toe injury McDuffie originally suffered in 1999, which eventually forced him to retire after eight effective seasons in the NFL. Several other doctors have settled with the wideout rather than go to court.

McDuffie spent most of his playing career catching passes from Dan Marino. He was reasonably successful in this role, hauling in 29 touchdown passes in his career. His best year came in 1998 when he caught 90 passes for 1,050 yards and scored seven touchdowns. He also returned two punts for scores in his 1993 rookie campaign.

The wrongful death lawsuit was brought against Coastal Anesthesia, Dr. Randal Boudreaux and Nurse Don Ortego following the January 2006 death of Paulett Pettaway Hall. The complaint alleged that Bourdreaux and Ortego, the anesthetist, failed to identify that Hall had risk factors for breathing fluid into her lungs, despite the information being available in her medical record.

Hall was preparing to receive exploratory surgery to determine the cause of severe stomach pains when she received the anesthesia. Once anesthetized, she began breathing bile into her lungs and later died. According to a report in the Mobile Press-Register, the family alleged that the defendants did not examine Hall’s abdomen or medical records before giving her anesthesia, which could have prevented her death.

Following trial, a Mobile County jury ruled in favor of the plaintiffs, and awarded $20 million in damages.

Anesthesia deaths accounted for more than 2,200 deaths between 1999 and 2005, according to a study published this year in the medical journal Anesthesiology. The study found that anesthesia is the underlying cause in about 34 deaths each year in the U.S., and a contributing factor in about 281 other deaths. A little over 46% of those deaths are due to anesthesia overdose, while anesthesia complications like Hall’s accounted for just under 11% of such deaths.

The first day started with a hands-on workshop on cadaveric spine, where minimally invasive techniques in spine surgery were demonstrated and practised by delegates in three separate sessions.

Dr Jens Timmerman from Germany, a pioneer in percutaneous lumbar discectomy, deomstrated his original technique of excision of disc without giving surgical incision to the delegates. Prof Patrik Kluger from Germany shared his experience in closed reduction of the dislocated cervical spine which is a life threatening injury. Dr. Hans Joseph Erli shared his experience of treatment of spinal problems using minimally invasive techniques. Prof Raj Bahadur from GMCH Chandigarh spoke on the complex injuries of the cervical spine where he demonstrated the technique of treatment of cervical PIVD and cervical pedicle screws- a new and emerging surgical technique.

Prof Arvind Jayaswal from AIIMS, New Delhi discussed the current trends and future directions of the surgical dissection, metallurgical advances and role of molecular technology in the management of spinal injuries.

Besides, video demonstrations of various surgical techniques were demonstrated by eminent national and international surgeons including Dr SK Abbas Uddin from Bangladesh, Vicky Sigworth and Dr Shankracharya. Dr HS Chhabra from Indian Spinal Injuries Center, New Delhi presented his experience of posterior approach alone for the correction of kyphotic deformities.

The result is an impressive, yet disheartening review of the healthcare system 10 years after the Institute of Medicine released its report, “To Err is Human”