ArticleBMC health services research2026
Fear of malpractice, anxiety levels, and defensive medicine practices among rhinoplasty surgeons: a cross-sectional study.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFear of malpractice can affect the psychological well-being and clinical decision-making processes of surgeons. This study aimed to evaluate fear of malpractice, generalized anxiety levels (GAD-7), and defensive medicine practices among rhinoplasty surgeons in Türkiye.
methodsA cross-sectional online survey was conducted among ENT and plastic surgeons performing rhinoplasty between August and September 2025. The survey included the 6-item Fear of Malpractice Scale, Generalized Anxiety Disorder-7 (GAD-7), and the 18-item Defensive Medicine Practices Attitude Scale. Descriptive statistics, correlation analyses, and multiple linear regression were performed.
resultsA total of 188 surgeons participated. 17% of the participants were female, 83% were male, and their mean age was 40.8 ± 6.7 years. The mean fear of malpractice score was 21.28 ± 6.17 (range 6-30). The mean GAD-7 score was 8.38 ± 4.13 (range 0-21). Female surgeons had higher GAD-7 scores than males (9.84 ± 4.21 vs. 8.06 ± 4.07, p = 0.038). Fear of malpractice correlated positively with GAD-7 (r = 0.34, p < 0.001) and defensive medicine scores (ρ = 0.32, p = 0.001). In multivariable regression analysis, higher malpractice fear (β = 0.29, p < 0.001), younger age (β = -0.11, p = 0.002), female gender (β = 1.21, p = 0.031), and working in private institutions (β = 2.46, p < 0.001) independently predicted higher anxiety levels (adjusted R² = 0.254).
conclusionsFear of malpractice is significantly associated with general anxiety and defensive medical practices among rhinoplasty surgeons. Balanced medico-legal training and institutional support can help reduce unnecessary defensiveness while protecting the patient's best interests in decision-making.
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