The practice of defensive medicine among hospital doctors in the United Kingdom

BMC Med Ethics. 2013 Oct 29;14:42. doi: 10.1186/1472-6939-14-42.


Background: Defensive medicine is defined as a doctor's deviation from standard practice to reduce or prevent complaints or criticism. The objectives of this study were to assess the prevalence of the practice of defensive medicine in the UK among hospital doctors and the factors affecting it.

Methods: A quantitative study was designed, with a detailed seventeen point questionnaire. Defensive medicine practice was assessed and tested against four factors age, gender, specialty and grade. Three hundred hospital doctors from three UK hospitals received the questionnaire.

Results: Two hundred and four (68%) out of 300 hospital doctors responded to the survey. Seventy eight percent reported practicing one form or another of defensive medicine. Ordering unnecessary tests is the commonest form of defensive medicine reported by 59% of the respondents. This is followed by unnecessary referral to other specialties (55%). While only 9% of the sampled doctors would refuse to treat high risk patients, double this number would avoid high risks procedures all together (21%). A linear regression module has shown that only senior grade was associated with less practice of defensive medicine.

Conclusion: Defensive medical practice is common among the doctors who responded to the survey. Senior grade is associated with less practice of defensive medicine.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Attitude of Health Personnel
  • Defensive Medicine / statistics & numerical data*
  • Female
  • Hospitalists / standards
  • Hospitalists / statistics & numerical data*
  • Humans
  • Linear Models
  • Male
  • Medical Staff, Hospital / statistics & numerical data
  • Medicine / statistics & numerical data
  • Middle Aged
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Prevalence
  • Sex Factors
  • Surveys and Questionnaires
  • United Kingdom / epidemiology