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. 2021 Dec;39(4):413-418.
doi: 10.1080/02813432.2021.1970945. Epub 2021 Aug 31.

Defensive medicine in Danish general practice. Types of defensive actions and reasons for practicing defensively

Merethe K Andersen  1 , Elisabeth Assing Hvidt  1   2 , Kjeld M Pedersen  3 , Jesper Lykkegaard  1 , Frans B Waldorff  4 , Anders P Munck  1 , Line B Pedersen  1   5
Affiliations

Defensive medicine in Danish general practice. Types of defensive actions and reasons for practicing defensively

Merethe K Andersen et al. Scand J Prim Health Care. 2021 Dec.

Abstract

Objective: To examine the occurrence of and types of defensive medicine (DM), and the reasons for practicing DM in general practice.

Design: Prospective survey registration of consecutive consultations regarding defensive medicine defined as: Actions that are not professionally well founded but are carried out due to demands and pressure. The GPs registered the degree of defensiveness, the type(s) of defensive action(s) and the reason(s) for acting defensively.

Setting: Danish general practice.

Subjects: A total of 26 GPs registered a total of 1,758 consultations.

Main outcome measures: Defensive medical actions.

Results: Defensive actions were performed in 12% (210/1749) of all consultations. A fifth (46/210) of the defensive actions were characterised by the GPs as 'moderately' or 'highly' defensive. Frequent types of defensive actions were: blood tests, point-of-care-tests (POCTs) and referrals. Common reasons for defensive actions were: Influence from patients, 37% (78/210), concerns of overlooking severe disease, 32% (67/210) and influence from patient relatives, 12% (25/210).

Conclusion: Danish GPs registered self-perceived defensive actions in a prospective survey. DM was carried out in one out of eight consultations, most often due to patient influence. The most frequent defensive actions were blood tests, POCTs and referrals.

Keywords: General practice; defensive actions; occurrence; reasons; types.

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Conflict of interest statement

All authors declare no conflict of interests.

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