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Master Thesis

Impact ressenti de la médecine défensive sur la pratique médicale

Abstract : Introduction: defensive medicine can be defined as the modification of practice in response to fear of litigation. Aim: Study the felt impact of defensive medicine on the practice of French general practitioners. Design: cross-sectional descriptive quantitative study carried out between January and March 2020 by two investigators with 185 general practitioners (GPs) randomly drawn from listed GPs of Gironde. This study follows a first focus group study that enabled the development of a 20-item survey distributed by telephone and secondarily anonymized. Results: a total of 132 GPs completed the survey (74,5 % response rate). 34.8 % of respondents declared a previous malpratice liability. When under forensic pressure, nearly all of respondents (98,5 %) said they had changed at least one aspect of their practice: 80.3 % changed their note-taking, 60.6 % ordered more imaging exams, 57.8 % more biology, 34.9 % changed their drug prescriptions. The main avoidance behaviors consisted in referring the patient more easily to a specialist colleague or to the emergency department (73.5 % and 27.3 % of respondents respectively) and for 54.4 % of them to give up the practice of technical acts deemed to be at risk. Physicians’ self-rated feelings regarding the impact of defensive medicine in their practice averaged 4.58 out of 10. A history of litigation was not significantly associated with a change in defensive behavior. Protective behaviors were spontaneously implemented to fight against the pressure: 74.2 % debriefed the difficult consultation with a colleague, 72.7 % gave more explanations to the patient. Conclusion: the concept of defensive medicine interests general practitioners. All of them seemed to be affected in their practice, but to varying degrees. Work on the patient/doctor relationship could prevent the development of these behavior.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03435622
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Submitted on : Thursday, November 18, 2021 - 6:08:56 PM
Last modification on : Friday, December 17, 2021 - 3:47:07 AM

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  • HAL Id : dumas-03435622, version 1

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Charles Morichon. Impact ressenti de la médecine défensive sur la pratique médicale. Médecine humaine et pathologie. 2021. ⟨dumas-03435622⟩

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