Policy Brief for Management and Prevention of Defensive Medicine in the Iranian Health System



Eftekhari MH¹ ; Parsapoor A² ; Ahmadi A³ ; Yavari N⁴ ; Shamsi Gooshki E⁵ Show Affiliations
Source: Iranian Journal of Medical Ethics and History of Medicine Published:2023

Abstract

Defensive medicine is performing actions that have no medical indication and benefit for the patient (positive defensive medicine) or refraining from performing risky actions that have a medical indication and benefit for the patient (negative defensive medicine). These actions are carried out by the physicians with the sole motive of protecting themselves against complaints or tensions such as the protest of the patient or colleagues and usually cause physical, psychological, or economic harm to the patient or the institution that pays the treatment fee, such as insurance organizations. It can have consequences in terms of the quality of care and the efficient use of limited health resources. Factors such as the physician’s concerns about lawsuits and proceedings may lead to defensive behaviors. This study presented suggestions for the management and prevention of such behaviors, including three main categories related to the strategies for the reformation of the patient complaint handling system, social strategies for the management and prevention of defensive medicine, and managerial-organizational strategies. These strategies are based on the findings of a mixed-methods research including an unsystematic review of resources and a qualitative study conducted using semi-structured interviews. The results have been discussed by the Medical Ethics Committee of the Academy of Medical Sciences of Iran. © 2023Tehran University of Medical Sciences.