Malpractice liability and defensive medicine in anesthesia: Egyptian anesthesiologists’ perspectives

Abstract

Background The threat of malpractice liability could alter anesthesiologists’ clinical attitudes and behavior leading them to practice defensive medicine (DM) which aims at protecting doctors from medicolegal claims.Purpose To explore the knowledge, attitude, and practice of Egyptian anesthesiologists towards DM and their attitude and previous experience regarding medical malpractice liability.Methods An online cross-sectional questionnaire was done on a convenience sample of anesthesiologists. The questionnaire involved physician data, knowledge, attitude, and practice regarding DM, their attitude and previous experience regarding medical malpractice liability, and justifications for practicing DM.Results The questionnaire was completed by 177 anesthesiologists. Only 10.7% of participants received training about malpractice liability. The concern of malpractice litigation was reported by 81.4% and 92.1% of participants thought that malpractice lawsuits will have a negative influence on their performance. Most of the anesthesiologists (70.6%) reported that at least one of their colleagues was named in malpractice lawsuits, while 32.7% of them reported being investigated for malpractices. Based on “Defensive Medicine Behavior Scale”, 61% of the participants had a very high score. The highest reported justification for DM was fatigue 27.7%.Conclusions Despite the fact that more than half of the participants’ knowledge of DM was insufficient, about 61% had a very high score for DM-related behaviors. This highlights the DM current situation among them which could endanger physicians’ proficiency, quality of care, patient rights, and cost. Efforts with medicolegal training should be made to keep physicians' risk perception and anxiety in balance to avoid DM.

Keywords

• Medical malpractice
• defensive medicine
• intensive care
• medical liability
• Egyptian anesthesiologists