Medical Journal of The Islamic Republic of Iran (MJIRI)
Iran University of Medical Sciences
Thu, Nov 7, 2024
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Volume 38, Issue 1 (1-2024)
Med J Islam Repub Iran 2024 |
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Zarei E, Yousefi I, Shiranirad S, Poursaki T, Zahmatkesh M M, Farrokhi P. Policy Options for Reducing Defensive Medicine Behaviors: A Multi-Method Study. Med J Islam Repub Iran 2024; 38 (1) :597-608
URL: http://mjiri.iums.ac.ir/article-1-9192-en.html
URL: http://mjiri.iums.ac.ir/article-1-9192-en.html
Ehsan Zarei 
, Iman Yousefi , Saba Shiranirad , Tahmineh Poursaki , Mohamad Mehdi Zahmatkesh , Pouria Farrokhi
, Iman Yousefi , Saba Shiranirad , Tahmineh Poursaki , Mohamad Mehdi Zahmatkesh , Pouria Farrokhi
Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran , p-farrokhi@student.tums.ac.ir
Abstract: (290 Views)
Background: Defensive medicine (DM) refers to taking or not taking clinical actions, mainly to prevent legal or reputational consequences. It increases patient and health system costs and threatens patient safety. This study aimed to provide policy options to reduce DM behaviors and was conducted in two phases.
Methods: First, a scoping review was conducted by searching the Web of Science, PubMed, ProQuest, and Scopus databases in 2000–2023, and interventions and strategies to control DM behaviors were identified. To recognize the advantages, disadvantages, and implementation considerations, one session of focus group discussion (FGD) with experts was designed. Finally, the policies, strategies, advantages, disadvantages, and implementation considerations were refined and categorized during two expert panel sessions.
Results: During the search, 1774 articles were retrieved. Finally, after the screening process, 58 articles were included in the study. Four main policy options were formulated: "evidence-based medicine," "legal reforms," "promotion of professional ethics and a supportive environment," and "improving the doctor-patient relationship." In the following, 13 interventions and strategies, 18 advantages, 18 disadvantages, and 21 implementation considerations were identified.
Conclusion: To manage and reduce the effects of DM behaviors, different interventions at macro, organizational, and individual levels are needed. At the micro and individual levels, the enhancement of knowledge and skills is valuable. Organizational interventions that create a supportive culture and promote ethical behavior are also important.
Methods: First, a scoping review was conducted by searching the Web of Science, PubMed, ProQuest, and Scopus databases in 2000–2023, and interventions and strategies to control DM behaviors were identified. To recognize the advantages, disadvantages, and implementation considerations, one session of focus group discussion (FGD) with experts was designed. Finally, the policies, strategies, advantages, disadvantages, and implementation considerations were refined and categorized during two expert panel sessions.
Results: During the search, 1774 articles were retrieved. Finally, after the screening process, 58 articles were included in the study. Four main policy options were formulated: "evidence-based medicine," "legal reforms," "promotion of professional ethics and a supportive environment," and "improving the doctor-patient relationship." In the following, 13 interventions and strategies, 18 advantages, 18 disadvantages, and 21 implementation considerations were identified.
Conclusion: To manage and reduce the effects of DM behaviors, different interventions at macro, organizational, and individual levels are needed. At the micro and individual levels, the enhancement of knowledge and skills is valuable. Organizational interventions that create a supportive culture and promote ethical behavior are also important.
Keywords: Defensive Medicine, Defensive Practice, Conflict Of Interest, Medical Malpractice, Lawsuits
Type of Study: Original Research |
Subject:
Medical Ethics
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