The first survey on defensive medicine among Iranian surgeons: prevalence and its related factors

Abstract

Introduction Defensive medicine (DM) is defined as the deviation of a physician from normal behavior or what is good practice aimed at decreasing or preventing from the complaints and criticism by the patients or their families. The current study aimed at examining DM behaviors in a sample of Iranian surgeons. Methods In this cross-sectional study, 235 surgeons were selected by systematic random sampling method. The data gathering tool was a researcher-made questionnaire which its validity and reliability were confirmed. For data analysis, Fisher's exact test, Kruskal-Wallis test, Chi-square and logistic regression tests were used in SPSS 21 software. Results The most common positive DM behaviors including unnecessary biopsy (78.7%), imaging and laboratory tests (72.3% and 70.6%), and refusing to accept high-risk patients (61.7%) was also the most common negative DM behavior among surgeons. The likelihood of DM behaviors was more in young and less experienced surgeons. Other variables such as gender, specialty and complaint history also had a positive effect on some DM behaviors (p <0.05). Conclusion Strategies such as reforming the rules and regulations for medical errors and patient complaints, increasing monitoring of service delivery, developing and implementing medical guidelines and evidence-based medicine, and reforming medical liability insurance system are effective to reduce DM behaviors in order to prevent its adverse effects on the health system and patients.