Physicians’ views and experiences of defensive medicine: An international review of empirical research

This study systematically maps empirical research on physicians’ views and experiences of hedging-type defensive medicine, which involves providing services (eg, tests, referrals) to reduce perceived legal risks. Such practices drive over-treatment low value healthcare. Data sources were empirical, English?language publications in health, multi-disciplinary databases. The extraction framework covered: where when the was conducted; what methods data collection used; who participants were; aims, main findings relation practices, proposed solutions. 79 papers met inclusion criteria. Defensive medicine has mainly been studied United States European countries using quantitative surveys. Surgery obstetrics have key fields investigation. Hedging-type commonly reported, including: ordering unnecessary treatments referrals; suggesting invasive procedures against professional judgment; hospitalisation or delaying discharge; excessive documentation medical records. practice often framed around threat negligence lawsuits, but studies recognised other risks, including patient complaints regulatory investigations. Potential solutions identified at macro (law, policy), meso (organisation, profession) micro (physician) levels. Areas for future include qualitative investigate behavioural drivers intervention determine policies that work support clinicians de-implementing defensive, low-value care.