TY - JOUR
T1 - Emergency physicians' experiences with defensive medicine and their motives for acting defensively - an interview study
AU - Mikkelsen, Thorbjørn Hougaard
AU - Brabrand, Mikkel
AU - Christensen, Anne Friesgaard
AU - Andersen, Merethe Kousgaard
PY - 2024
Y1 - 2024
N2 - BACKGROUND: Defensive medicine (DM) has been increasingly studied in recent years. This study aims to investigate the understanding of DM and the motives for practicing DM among emergency physicians. METHODS: Focus group interviews. RESULTS: Themes identified: The understanding of DM, DM is a matter of self-confidence, DM or tests to ensure diagnosis and patient flow, DM due to confounding by availability, DM due to guidelines, Patient-initiated DM, Fear of complaints, DM in an emergency department setting. CONCLUSION: This study shows that emergency physicians perform an abundance of diagnostic tests and investigations but only categorize few of them as DM. The many flow-mediating tests based on guidelines may, however, mask activities that individual physicians would possibly find defensive, if it was up to them to decide based on pure and simple anamnesis and clinical findings. It might be argued that flow optimization has overruled medical clinical reasoning in some ways, thereby introducing an inclination to conduct DM.
AB - BACKGROUND: Defensive medicine (DM) has been increasingly studied in recent years. This study aims to investigate the understanding of DM and the motives for practicing DM among emergency physicians. METHODS: Focus group interviews. RESULTS: Themes identified: The understanding of DM, DM is a matter of self-confidence, DM or tests to ensure diagnosis and patient flow, DM due to confounding by availability, DM due to guidelines, Patient-initiated DM, Fear of complaints, DM in an emergency department setting. CONCLUSION: This study shows that emergency physicians perform an abundance of diagnostic tests and investigations but only categorize few of them as DM. The many flow-mediating tests based on guidelines may, however, mask activities that individual physicians would possibly find defensive, if it was up to them to decide based on pure and simple anamnesis and clinical findings. It might be argued that flow optimization has overruled medical clinical reasoning in some ways, thereby introducing an inclination to conduct DM.
U2 - 10.52964/AMJA.0988
DO - 10.52964/AMJA.0988
M3 - Journal article
C2 - 39513262
AN - SCOPUS:85209166686
SN - 1747-4884
VL - 23
SP - 132
EP - 139
JO - Acute Medicine
JF - Acute Medicine
IS - 3
ER -