ArticlePostgraduate medical journal2002
Defensive practice among psychiatrists: a questionnaire survey.
Article in Postgraduate medical journal, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 65 citations in OpenAlex.
- How defensive medicine is defined in European medical literature: a systematic review.BMJ open · 2022Pooled it
- Defensive medicine-related practices among child and adolescent psychiatrists in Türkiye: prevalence, behavioral patterns, and associated factors.Frontiers in psychiatry · 2026Article
- Prevalence of defensive medicine behaviors, associated risk factors and its mitigation strategies among physicians in Gaza Strip, palestine: a mixed method study.BMC medical ethics · 2025Article
- Ethical challenges in contemporary psychiatry: an overview and an appraisal of possible strategies and research needs.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2024Article
- Defensive medicine practices as a result of malpractice claims and workplace physical violence: a cross-sectional study from Egypt.Scientific reports · 2023Article
- Predictors of Defensive Practices among Italian Psychiatrists: Additional Findings from a National Survey.Medicina (Kaunas, Lithuania) · 2023Article
- Psychiatrists' occupational stigma conceptualization, measurement, and intervention: A literature review.World journal of psychiatry · 2023Review
- Article
- The occurrence, types, reasons, and mitigation strategies of defensive medicine among physicians: a scoping review.BMC health services research · 2022Article
- Psychiatric Risk Assessment from the Clinician's Perspective: Lessons for the Future.Community mental health journal · 2019Article
- Triggers of defensive medical behaviours: a cross-sectional study among physicians in the Netherlands.BMJ open · 2019Article
- Cross-sectional survey on defensive practices and defensive behaviours among Israeli psychiatrists.BMJ open · 2017Article
- Perspectives and practical applications of medical oncologists on defensive medicine (SYSIPHUS study): a study of the Palliative Care Working Committee of the Turkish Oncology Group (TOG).Medical oncology (Northwood, London, England) · 2015Article
- Defensive medicine in Israel - a nationwide survey.PloS one · 2012Article
- Professionally responsible malpractice reform.Journal of general internal medicine · 2011Article
- Defensive medicine, cost containment, and reform.Journal of general internal medicine · 2010Review
- Dynamic confidence during simulated clinical tasks.Postgraduate medical journal · 2005Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThere has been little research on the prevalence of defensive practice within hospital settings. The aim of this report was to examine the extent of defensiveness among psychiatrists and to examine the relationship between defensiveness and seniority, as well as the effect of previous experiences on the level of defensiveness.
designA postal questionnaire survey on defensive practice.
settingNorthern Region of England. SUBJECTS: 154 psychiatrists in the region.
results96 responses were received from 48 equivalent consultants, 18 specialist registrars, and 23 equivalent senior house officers. Overall, 75% of those who replied had taken defensive actions within the past month. In particular, 21% had admitted patients overcautiously and 29% had placed patients on higher levels of observations. Junior psychiatrists were particularly prone to practise defensively. Important contributing factors included previous experience of complaints (against colleague or self), critical incidents, and legal claims.
conclusionAlmost three quarters of the psychiatrists who responded had practised defensively within the past month. The higher propensity of junior trainees to practise defensively may be attributable to their lack of confidence and experience. Experience of complaints (colleague or self) and critical incidents were important factors for defensive practice. Better and more structured training might reduce the high level of defensive practice and the way complaints and investigations are handled should be improved to maintain a truly "no blame" environment conducive to learning from past experience.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.