Why do Doctors practice defensive medicine? The side-effects of medical litigation

Defensive medicine takes place when doctors prescribe unnecessary tests, procedures or specialist visits (positive defensive medicine), or avoid high risk patients or procedures (negative defensive medicine). Doctors practice defensive medicine in order to reduce their exposure to medical malpractice litigation. This paper reports the results of two studies - one national and one conducted at a regional hospital - on the type, extent, and motivations of defensive behaviours adopted by doctors in Italy. Findings suggest that about 4/5 of the doctors admit having practiced defensive medicine at least once in the previous month. This paper discusses the factors - such as the blame culture and the increase in medical malpractice litigation - that prompt defensive behaviours, thus increasing patient risks, and the cost of healthcare system.