Defensive Medicine At Its Worst

On Friday I scrubbed a complicated orthopedic case that took about 4-5 hours involving the cutting of bone, and insertion of screws. Typically I order a post-operative x-ray while the patient is in recovery to make sure everything is in allignment and all of the hardware is in place. This is what I was instructed to do as a student and during my early residency training. I ordered the x-ray, and was beginning to preop the next patient when the attending physician approached me looking angry. "Never order a post-operative x-ray on my patients!! Do you understand?" Seeing that I responded calmly with an "ok, no problem," his tone softened.."you are just setting yourself up for a lawsuit" he said. "If you want a postoperative x-ray, take it in your office. There you will be the only person looking at it, and no one else will be able find anything wrong with your work." I am sure he thought he was giving me a good piece of practice managment advice..a tip on how to avoid a lawsuit, but in my mind, this was verging on the brink of malpractice. We are told that malpractice is anything that goes against the "standard of care," and the standard of care is to take a post operative x-ray in the hospital. We often hear about how doctors are scared into ordering too many tests on patients for fear of missing something and being sued, but here is an example of a doctor not doing something for a patient out of the same fear.