Abstract
BackgroundDefensive medicine is defined as a doctor’s deviation from standard practice to reduce or prevent complaints or criticism. The objectives of this study were to assess the prevalence of the practice of defensive medicine in the UK among hospital doctors and the factors affecting it.MethodsA quantitative study was designed, with a detailed seventeen point questionnaire. Defensive medicine practice was assessed and tested against four factors age, gender, specialty and grade. Three hundred hospital doctors from three UK hospitals received the questionnaire.ResultsTwo hundred and four (68%) out of 300 hospital doctors responded to the survey. Seventy eight percent reported practicing one form or another of defensive medicine. Ordering unnecessary tests is the commonest form of defensive medicine reported by 59% of the respondents. This is followed by unnecessary referral to other specialties (55%). While only 9% of the sampled doctors would refuse to treat high risk patients, double this number would avoid high risks procedures all together (21%). A linear regression module has shown that only senior grade was associated with less practice of defensive medicine.ConclusionDefensive medical practice is common among the doctors who responded to the survey. Senior grade is associated with less practice of defensive medicine.
Highlights
Defensive medicine is defined as a doctor’s deviation from standard practice to reduce or prevent complaints or criticism
All the three hospitals are from National Health Service (NHS), none is private, for ethical reason we could not reveal the names of the three hospitals
Defensive medicine practice is common among hospital doctors who responded to our survey
Summary
Defensive medicine is defined as a doctor’s deviation from standard practice to reduce or prevent complaints or criticism. The objectives of this study were to assess the prevalence of the practice of defensive medicine in the UK among hospital doctors and the factors affecting it. Whilst the general public is better informed, they have become more risk averse, often refusing to accept the usually low probability of adverse outcomes associated with medical care and interventions [3]. This encourages doctors to avoid actions that may create risk, such that they act defensively, ordering tests not on medical grounds, but to alleviate the possibility of potential complaints or litigation. A ‘more defensible’ case is created, if litigation were to occur [4]
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