Study on Defensive Medicine Practices among Obstetricians and Gynecologists Who Provide Breast Care

Abstract

The purpose of this study was to assess malpractice concerns, career satisfaction, defensive medicine, experience with liability lawsuits, and changes in breast care practices among obstetricians and gynecologists (ob-gyns) who provide breast care. Four hundred ACOG Fellows were randomly selected and invited to participate, 247 (62%) responded. A majority of responders had increased the number of referrals for the diagnosis of breast abnormalities (58.9%) and treatment of breast disease (53.6%) due to fears and concerns regarding malpractice. On average, there was a high level of career satisfaction (M=8.5 [SD=2.5] on a scale from 0 to 10); however, those who had been sued were significantly less satisfied than those who had not. Physicians who had decreased breast surgical procedures and increased referrals for diagnosis and treatment of breast disease reported practicing defensive medicine more frequently. In a regression analysis, having been sued was a significant predictor of practicing defensive medicine more often. Physicians from states with malpractice crisis reported practicing defensive medicine more frequently and more lawsuits than physicians from stable states. Malpractice fears and defensive medicine continue to affect the practices of ob-gyns, most specifically, as this study shows, ob-gyns who provide breast care.

Comparing Physicians Personal Prevention Practices and Their Recommendations to Patients

“…Thus, personal prevention choices and patient recommendations were compared within subjects. Frequency of defensive medicine practices was estimated by asking physicians how often they tend to recommend more screening than medically necessary due to malpractice concerns 1 (Anderson, Strunk, & Schulkin, 2011). The response scale varied from 0 (never) to 10 (always).…”

Prevalence and costs of defensive medicine: a national survey of Italian physicians

“…2,4,7 The percentage of doctors practising DM is higher for some specialties, especially obstetrics and gynaecology (97%), gastroenterology (94-98%), neurosurgery (75-83%), and orthopaedics and traumatology (96%). 5,[8][9][10][11][12][13][14][15][16][17] The practice of DM is a significant financial burden on health care systems. In the United States, DM is estimated to cost US $50-100 billion annually.…”

How defensive medicine is defined in European medical literature: a systematic review

“…(6) The study includes data from Europe. *USA,11 12 14 76–145 New Zealand,74 75 146 147 China,148–150 Japan,151 152 Iran,153 Israel,154–160 Sudan,161 Canada,162 163 Australia,164 165 South Africa,166 Singapore,167 India,168 Hong Kong,169 Brazil170 and one study from both USA, Canada and South Africa 73…”