The first survey on defensive medicine in radiation oncology

Abstract

Purpose: Defensive Medicine occurs when doctors order tests, procedures, visits or avoid high-risk patients and procedures, primarily to reduce their exposure to malpractice liability. Some medical specialities are at "high-risk" for legal argument, but no data is actually available for radiation oncology. We present here the first survey of radiation oncologists' views regarding malpractice liability and defensive medicine practice.

Materials and methods: A three-page questionnaire was sent to 611 active radiation oncologists, members of the Italian Association of Radiation Oncology (AIRO), with questions pertaining to the incidence, nature and causes in their practice of defensive medicine.

Results: A total of 361 questionnaires were completed (59 % feedback). Physicians practise defensive medicine by ordering further imaging studies (39 %) or laboratory tests (35 %), referring patients to consultants (43 %) or prescribing additional medication (35 %). Approximately, 70 % declared that the climate of opinion that exists towards doctors is one of the major issues for practising defensive medicine.

Conclusion: Although radiation oncology is generally considered a "medium/low risk" speciality for defensive medicine, the present survey reflects a widespread use of this behaviour in daily practice. Investigating which radiation oncologist categories are more prone to defensive medical behaviour can be advantageous for implementing programmes aimed at improving awareness of this phenomenon and to increase good clinical practice.