THE PERCEPTION OF PHYSICIANS ON DEFENSIVE MEDICINE AND DECISION-MAKING IN SUPPLY OF HEALTH CARE SERVICES
Mehmet YORULMAZ- Hatice SABIRLI
Published 2019-06-26
Keywords
- Defensive Medicine,
- Malpractice,
- Decision Making
- Defansif Tıp,
- Malpraktis,
- Karar Verme
How to Cite
How to Cite
Abstract
Objective: The aim of this study was to investigate the relationship between defensive medicine and the decision-making perceptions of physicians in the supply of health services.
Materials and Methods: In this study, four different private hospitals in the province of Konya (Academi Meram Hospital, Akademi Konya Hospital, Farabi Hospital and Konya Eye Hospital) were applied to the prescribing physicians. Using qualitative research design, 102 physicians, 32 females and 70 males, participated in the study. Sampling method was used to create the sample group and the survey technique was used to collect the data. In the study, ‘personal information form’ containing demographic information was prepared. In order to measure the perception of physicians' decision making, the Decision-Making Styles Scale, which was developed by Scott and Bruce (1995) and adapted by Taşdelen (2002) was used. Defensive Medical Attitude Scale, which was developed Başer et al. (2014) was used.
Results: Of the participating physicians, 31.4% were female and 68.6% were male. 39.2% of the participants were in the 35-44 age range. Considering the units studied, most of the physicians work in internal units as 44.1%. It was observed that 60.8% of the participants were doctors with the experience of 11 years or more. As far as the parentage rates are concerned, it is found that 39.2% have 2 children. A negative low rate correlation was found between the decision making and defensive medicine. The relationship between the decision making and defensive medicine attitudes of physicians was examined and as a result, there was a low negative correlation between decision-making styles and defensive medicine (r = -. 229; p<0.05). T test analysis was performed in interdependent groups, no significant difference was observed among defensive medicine and decision-making mean scores, and sex and marital status variables.. 13 physicians (2.7%) answered in the affirmative to the question of “Is there a case for malpractice in the process of your medical profession?” 56 physicians (54.9%) answered negatively to the question “Do you have enough information about the contents of the concept of defensive medical practice?”
Conclusion: According to the results of our study, physicians do not have enough knowledge about defensive medicine and they have a tendency to show depressive medicine behavior.
References
- Adwok, J., Kearns, EH. (2013). Defensive Medicine: Effect on Costs, Quality, and Access to Healthcare. Journal of Biology, Agriculture and Healthcare, ISSN 2225-093X (Online) Vol.3, No.6, 2013
- Aynacı. Y. (2008). Hekimlerde Defansif (Çekinik) Tıp Uygulamalarının Araştırılması, Selçuk Üniversitesi, Meram Tıp Fakültesi, Adli Tıp Ana Bilim Dalı, Tıpta Uzmanlık Tezi, Konya. s.2.
- Başer A., Kolcu G., Çığırgil Y., Kadınkız B., Öngel K. (2014). İzmir Karşıyaka İlçesinde Görev Yapan Aile Hekimlerinin Defansif Tıp Uygulamaları ile İlgili Görüşlerinin Değerlendirilmesi. Smyrna Tıp Dergisi 16:24.
- Conroy A. (2006).LessonsLearnedfromthe ‘Laboratories of Democracy’: A Critique of Federal MedicalLiabilty Reform,’’ Cornell LawRaview. 91(5):1167.
- Dedeoğlu. A.K. (2012). Özel Hastanelerde Çalışan Hekimlerin Tıbbi Müdahale ve Tedavide Malpraktisten Doğan Hukuki ve Cezai Sorumluluklarına İlişkin Farkındalık Düzeylerinin Ölçümü: Ankara İli Özel Hastaneler Uygulaması, Atılım Üniversitesi Sosyal Bilimler Enstitüsü Sağlık Kurumları İşletmeciliği Ana Bilim Dalı, Yüksek Lisans Tezi, Ankara.
- Null, G, Caroly, D, Feldman M, Rasio, D, Smith D.(2003). Death by Medicine, Nutrition Institute of America, Inc. (NIA, Inc.).
- Miller, R. (2006). Problems in health care law (3rd ed). Sudbury, MA: Jones and Bartlett
- Ovalı, F. (2010). Hasta Güvenliği Yaklaşımları.Sağlıkta Performans ve Kalite Dergisi, 1 (1), 33-43.
- Panting, G. (2005). “Doctors on the Defensive”, http://www.theguardian.com/society/2005/apr/01/
- health.comment, (Erişim Tarihi: 26 Şubat 2016).
- Pirol, M. (2018). Hekimlerin Karar Verme Algılarının Defansif Tıp Tutumları Üzerine Etkisinin Araştırılması, Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü Sağlık Yönetimi Ana Bilim Dalı, Yüksek Lisans Tezi, Konya.
- Scott, SG., Bruce, R.A. (1995). Decision making style, the development and of a new measure. Educational and Psychological Measurement, 55(5).
- Selçuk, M. (2015). Çekinik (Defansif) Tıp, İzmir Üniversitesi Sosyal Bilimler Enstitüsü Sağlık Hukuku, Yüksek Lisans Tezi, İzmir.
- Studdert, D. M., Mello, M. M., Sage, W. M., DesRoches, C. M., Peugh, J, Zapert, K., Brennan, TA. (2005). “Defensive Medicine Among High Risk Specialist Physicians in a Volatile Malpractice Environment”, JAMA Internal Medicine, 293(21), 2609-2617.(doi:10.1001/jama.293.21.2609).
- Taşdelen, A. (2002). Öğretmen adaylarının farklı psiko sosyal değişkenlere göre karar verme stilleri. (Doktora tezi). Dokuz Eylül Üniversitesi, Eğitim Bilimleri Enstitüsü, İzmir.
- White, K. (2005). Medical Malpractice. A crisis in cost and access. Nursing Management, 36(3), 22-25