Emergency physicians' experiences with defensive medicine and their motives for acting defensively - an interview study.

Q3 Medicine Acute Medicine Pub Date : 2024-01-01 DOI:10.52964/AMJA.0988

Thorbjørn Hougaard Mikkelsen, Mikkel Brabrand, Anne Friesgaard Christensen, Merethe Kousgaard Andersen

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引用次数: 0

Abstract

Background: Defensive medicine (DM) has been increasingly studied in recent years. This study aims to investigate the understanding of DM and the motives for practicing DM among emergency physicians.

Methods: Focus group interviews.

Results: Themes identified: The understanding of DM, DM is a matter of self-confidence, DM or tests to ensure diagnosis and patient flow, DM due to confounding by availability, DM due to guidelines, Patient-initiated DM, Fear of complaints, DM in an emergency department setting.

Conclusion: This study shows that emergency physicians perform an abundance of diagnostic tests and investigations but only categorize few of them as DM. The many flow-mediating tests based on guidelines may, however, mask activities that individual physicians would possibly find defensive, if it was up to them to decide based on pure and simple anamnesis and clinical findings. It might be argued that flow optimization has overruled medical clinical reasoning in some ways, thereby introducing an inclination to conduct DM.

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急诊医生的防御性医疗经验及其采取防御性行动的动机--访谈研究。

背景：近年来，对防御性医疗（Defensive Medicine，DM）的研究越来越多。本研究旨在调查急诊科医生对防御医学的理解以及实施防御医学的动机：方法：焦点小组访谈：结果：确定了主题：对 DM 的理解、DM 是自信心的问题、DM 或检查以确保诊断和患者流量、DM 因可用性而混淆、DM 因指南而产生、患者主动 DM、对投诉的恐惧、急诊科环境中的 DM：本研究表明，急诊医生进行了大量的诊断测试和检查，但只有少数测试和检查被归类为 DM。然而，根据指南进行的许多流程中介检查可能会掩盖一些医生可能会认为具有防御性的活动，如果由他们根据纯粹而简单的病史和临床发现来决定的话。可以说，流程优化在某些方面已经压倒了医学临床推理，从而引入了进行 DM 的倾向。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acute Medicine Medicine-Emergency Medicine

CiteScore

1.50

自引率

0.00%

发文量

期刊介绍： These are usually commissioned by the editorial team in accordance with a cycle running over several years. Authors wishing to submit a review relevant to Acute Medicine are advised to contact the editor before writing this. Unsolicited review articles received for consideration may be included if the subject matter is considered of interest to the readership, provided the topic has not already been covered in a recent edition. Review articles are usually 3000-5000 words and may include tables, pictures and other figures as required for the text. Include 3 or 4 ‘key points’ summarising the main teaching messages.