Physicians’ defensive medicine practices: a cross sectional study in Cairo

Tawfik, Walaa Talaat; Mostafa, Hanan Hamed; Azab, Sonya; Hassan, Shaimaa

doi:10.21608/ajfm.2025.398160.1169

Physicians’ defensive medicine practices: a cross sectional study in Cairo

Document Type : Original Article

Authors

¹ Forensic medicine and clinical toxicology department , Faculty of medicine, Ain Shams university, Cairo, Egypt

² Forensic Medicine and clinical toxicology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

³ Forensic Medicine and clinical Toxicology Department, Faculty of Medicine, Ain Shams University, Cairo,Egypt

⁴ Forensic medicine and clinical toxicology department, Faculty of medicine, Ain Shams university, Cairo, Egypt

10.21608/ajfm.2025.398160.1169

Abstract

Background: Defensive Medicine (DM) refers to any medical care that physicians deliver without improving the patient's benefits. The practice of DM has been more widespread globally in recent decades due to the increasing number of lawsuits filed against doctors in all medical specialties. This study aimed to study reported practices of DM by physicians working in Cairo and its associated factors. Methods: cross-sectional study was conducted on 580 physicians with durations of work experience exceeding two years from all specialties who are working at different health care facilities in Cairo which were categorized into teaching hospitals (included university hospitals and teaching hospitals affiliated to the Ministry of Health (MOH), health care facilities affiliated to MOH (included all health care centers and hospitals other than teaching hospitals), and private health care facilities. An online self-administered structured questionnaire was used for data collection. Results: Positive defensive practices were more common than negative (avoiding) practices; unnecessary consultation of senior colleagues was the most common practice, followed by making unnecessary follow-up visits. Avoiding management of high-risk patients was the most common negative DM practices, followed by avoiding high-risk procedures. Physicians who were litigated of malpractice showed significant increases in frequency of reporting the following DM practices. Conclusion: Positive DM practices were more common than negative practices, and unnecessary consultation of an expert was the most common practice, followed by unnecessary frequent follow-up. There was an association between DM practices and physicians’ exposure to litigation of malpractice.

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