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Health Transformation Project and Defensive Medicine Practice among Neurosurgeons in Turkey

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  • Ihsan Solaroglu
  • Yusuf Izci
  • H Gokce Yeter
  • M Mert Metin
  • G Evren Keles

Abstract

Background: The term “Defensive” medicine was coined in the early 1970′s and has been an important topic of scientific investigation and professional debate ever since. Objective: The aim of this study was to investigate the characteristics of defensive medicine, its reasons, and the extent to which it is practiced in the Turkish health care system. This is the first national survey to study the practice of defensive medicine among neurosurgeons in Turkey. Methods: The present cross-sectional study on defensive medicine assessed neurosurgeons registered at the Turkish Neurosurgical Society, who are actively working in various centers and hospitals within the Turkish health care system. A 40-question survey was adapted from existing measures described in the literature and was completed by a total of 404 neurosurgeons, representing 36.7% of the neurosurgeons registered at the Turkish Neurosurgical Society. Results: Seventy-two percent of the participants in the current study reported practicing defensive medicine. This practice was mainly reported among inexperienced neurosurgeons (74.4%). Most were younger than 40 years of age (75.2%), working in state hospitals/universities (72.7%), and living in the Marmara region (38%). Respondents reported engaging in defensive medicine by avoiding high-risk surgery (62.6%), ordering additional imaging studies (60.9%) and laboratory tests (33.7%), and referring patients to consultants (31.2%). Most participants consider every patient as a potential threat in terms of a medical lawsuit (68.3%) and do not believe the courts can distinguish malpractice from complications (89.6%). Conclusion: Concerns and perceptions about medical liability lead neurosurgeons to practice defensive medicine. By avoiding high-risk surgery, ordering unnecessary diagnostic tests, and referring the patients to consultants, neurosurgeons try to minimize the risk of malpractice and protect themselves from legal risks, resulting in higher healthcare expenditure and longer treatment periods.

Suggested Citation

  • Ihsan Solaroglu & Yusuf Izci & H Gokce Yeter & M Mert Metin & G Evren Keles, 2014. "Health Transformation Project and Defensive Medicine Practice among Neurosurgeons in Turkey," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-7, October.
    • Handle: RePEc:plo:pone00:0111446
    DOI: 10.1371/journal.pone.0111446
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    References listed on IDEAS

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    1. Eberhard Feess, 2012. "Malpractice liability, technology choice and negative defensive medicine," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(2), pages 157-167, April.
    2. Elad Asher & Shay Dvir & Daniel S Seidman & Sari Greenberg-Dotan & Alon Kedem & Boaz Sheizaf & Haim Reuveni, 2013. "Defensive Medicine among Obstetricians and Gynecologists in Tertiary Hospitals," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-5, March.
    3. Brian V Nahed & Maya A Babu & Timothy R Smith & Robert F Heary, 2012. "Malpractice Liability and Defensive Medicine: A National Survey of Neurosurgeons," PLOS ONE, Public Library of Science, vol. 7(6), pages 1-7, June.
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    1. Ries, Nola M. & Jansen, Jesse, 2021. "Physicians’ views and experiences of defensive medicine: An international review of empirical research," Health Policy, Elsevier, vol. 125(5), pages 634-642.
    2. Dilek BAŞAR & İlhan Can ÖZEN & Selcen ÖZTÜRK & Ekim GÜMELER & Deniz AKATA & Arbay Özden ÇİFTÇİ, 2019. "The Case of MRI Repetitions with Direct and Indirect Cost Implications: Evidence from Hacettepe University Hospitals," Sosyoekonomi Journal, Sosyoekonomi Society, issue 27(41).

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