Determining the Frequency of Defensive Medicine Among General Practitioners in Southeast Iran

Document Type : Original Article

Authors

1 Health Deputy, Mazandaran University of Medical Sciences, Sari, Iran

2 Zabol University of Medical Sciences, Zabol, Iran

3 Research Center for Health Services Management, Kerman University of Medical Sciences, Kerman, Iran

4 Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran

Abstract

Background
Defensive medicine prompts physicians not to admit high-risk patients who need intensive care. This phenomenon not only decreases the quality of healthcare services, but also wastes scarce health resources. Defensive medicine occurs in negative and positive forms. Hence, the present study aimed to determine frequency of positive and negative defensive medicine behaviors and their underlying factors among general practitioners in Southeast Iran.
 
Methods
The present cross-sectional study was performed among general practitioners in Southeast Iran. 423 subjects participated in the study on a census basis and a questionnaire was used for data collection. Data analysis was carried out using descriptive and analytical statistics through SPSS 20.
 
Results
The majority of participants were male (58.2%). The mean age of physicians was 40 ± 8.5. The frequency of positive and negative defensive medicine among general practitioners in Southeast Iran was 99.8% and 79.2% respectively. A significant relationship was observed between working experience, being informed of law suits against their colleagues, and committing defensive medicine behavior (P< 0.001).
 
Conclusion
The present study indicated high frequency of defensive medicine behavior in the Southeast Iran. So, it calls policy-makers special attention to improve the status quo.

Keywords

Main Subjects

References

1.  Studdert DM, Mello MM, Brennan TA. Medical malpractice. N Engl J Med2004; 350: 283–92. doi: 10.1056/NEJMhpr035470
2.  Thompson MS, King CP. Physician perceptions of medicalmalpractice and efensivemedicine. Eval Program Plann 1984; 7: 95–104.
3.  Bassett  KL,  Lyer  N,  Kazanjian  A.  Defensive  medicine  during hospital  obstetrical  care:  a  by-product  of  the  technological  age. Soc Sci Med 2000;  51:  523–37.
dx.doi.org/10.1016/s0277-9536(99)00494-3
4.  Nelson  LJ,  Morrisey  MA,  Kilgore  ML.  Damages caps in medical malpractice cases. Milbank Q2007; 85: 259–86. doi: 10.1111/j.1468-0009.2007.00486.x
5.  Sloan FA, Shadle JH. Is there empirical evidence for? Defensive Medicine? A reassessment. J Health Econ 2009; 28: 481–91. doi: 10.1016/j.jhealeco.2008.12.006
6.  Brilla[A1]  R, Evers S, Deutschlander A, Wartenberg KE. Are Neurology residents in the United States being taught defensive medicine? Clin Neurol Neurosurg2012; 108: 374–7. doi:10.1016/j.clineuro.2005.05.013
7.  Tussing A D, Wojtowycz MA. Malpractice, defensive medicine, and obstetric behavior. Med Care1997; 35: 172–91. doi: 10.1097/00005650-199702000-00007
8.  Moher  JC. American  Medical  Malpractice  Litigation  in  Historical Perspective. JAMA 2000;  283:  1731–7. doi:10.1001/jama.283.13.1731
9.  Studdert  DM,  Mello   MM,  Sage  WM,  Desroches   CM,  Peugh  J, Zepert   K, et al.  Defensive  medicine  among  high-risk  specialist physicians in a volatile malpractice environment. JAMA2005; 293: 2609–17.
10.  Hiyama T, Yoshihara M, Tanaka SH, Urabe Y, Ikegami Y, Fukuhara T, et al.Defensive medicine practices among gastroenterologists in Japan. World J Gastroenterol2006; 12: 7671–5.
11.  Summerton N. Positive and negative factors in defensive medicine: a  questionnaire  study  of  general  practitioners. BMJ1995; 310: 27–9. doi: http://dx.doi.org/10.1136/bmj.310.6971.27
12.  Rafizadehtabatabaei  M,  Hajmanoochehry  R,  Nassajizavareh M. [The survey of prevalence of Malpractice of Medical General inThe  complaints  referred  to  Commission  on  Medico  legal  in Tehran center from 2003 to 2005 years].SJFM2007; 13: 152–7.
13.  Catino  M.  Why  do  Physicians  practice  defensive  medicine?  the side-effects of medical litigation. Safety Science Monitor2011; 15: 1–12.
14.  Brilla R, Evers S, Deutschlander A, Wartenberg KE. Are Neurology residents in the United States being taught defensive medicine? Clin Neurol Neurosurg2012; 108: 374–7. doi:10.1016/j.clineuro.2005.05.013
15.  Kessler D, McClellan M. Do physicians practice defensive medicine? Q J Econ1996; 111: 353–90.
16.  Klingman   D,  Wagner  JL,  Polishuk  PT,  Wolfe  L,  Corrigan  JA. Measuring defensive medicine using clinical scenario surveys. J Health Polit Policy Law 1996;  21:  185–217. doi: 10.1215/03616878-21-2-185
17.  Kessler D, Sage WM, Becker DJ. Impact of malpractice reforms on the supply of physician services. JAMA2005; 293: 2618–25. doi: 10.1001/jama.293.21.2618
18.  Cunningham W, Dovey S. Defensive changes in medical practice and the complaints process: a qualitative study of New Zealand doctors. N Z Med J 2006; 119: U2283.
19.  Studdert DM, Mello MM, Brennan TA. Defensive medicine and tort reform: a wide view. J Gen Intern Med2010; 25: 380–1. doi: 10.1007/s11606-010-1319-8
20.  Baicker  K,  Chandra  A.  Defensive  medicine  and  disappearing physicians. Regulation 2005;  28:  24.
 

Files

History

  • Receive Date: 01 January 2014
  • Revise Date: 19 March 2014
  • Accept Date: 12 March 2014
  • First Publish Date: 01 April 2014

Share

How to cite

Statistics