Defensive Medicine and Perceived Benefit from Medico-Legal Education Among Clinicians

Background

Defensive medicine is commonly linked to fear of legal processes and limited medico-legal knowledge. This study aimed to evaluate the association between defensive medicine and perceived benefit from medico-legal training, and changes in self-reported legal knowledge.

Methods

This analytical cross-sectional study with a pre-post educational component was conducted among clinicians of a training and research hospital in Turkey between October 2023-January 2024. Of 227 clinicians, 132 participated (58%). Participants completed the Defensive Medicine Practices Scale (DMPS) under observation, received a 25-minute medical law training session about medico-legal processes and criminal and financial liability as individuals or in small groups by a medical lawyer. Self-rated legal knowledge was scored before and after training. Perceived training benefit and need for periodic trainings were also assessed.

Results

Mean perceived training benefit was 7.70/10 (SD = 2.03; n = 131). DMPS scores were positively correlated with perceived benefit (Spearman’s rho=0.351, p < 0.001; n = 125). Physicians with any positive DMPS response (n = 123) perceived greater training benefit than those with no defensive medicine practices (n = 7) (p < 0.001). The association remained significant after adjustment for age, sex, and professional experience. Overall, 94.7% of participants (n = 125) wanted periodic medico-legal training, and mean self-reported legal knowledge increased from 3.79 to 5.44 after training (p < 0.001; n = 132).

Conclusions

Participants with higher DMPS scores perceived greater benefit from the training, suggesting greater educational need among those engaging in defensive practices. Brief structured training improved self-reported legal knowledge, and the high demand for periodic education indicates that one-time interventions may be insufficient. Making legal processes more familiar to physicians may help reduce uncertainty and address defensive medicine.

Key messages

• One of the most important interventions in combating defensive medicine may be to make legal processes no longer “unknown” for physicians.

• Brief medico-legal training improved self-reported legal knowledge and highlighted the need for periodic education.