The Effects of Defensive Medicine in Physician–Patient Dynamics: An Agent-Based Approach

We analyze different scenarios of defensive medicine in a novel framework based on game theory and network analysis, where links in the network represent healing relationships between a physician and a patient. The physician should choose between providing the optimal treatment or an inferior one, which can amount to practicing defensive medicine. The patient should choose whether to litigate or not if an adverse event occurs. A major result of such analysis is that the steady state does not depend on the litigiousness of the initial system or the initial distribution of strategies among physicians or the distribution of patients over physicians. Moreover, reaching a virtuous steady state or an entirely defensive one appears to be independent of the fact that patients take into account the quality of treatments directly or they rely merely on popularity when choosing their physicians.