Study of Medical Students' Malpractice Fear and Defensive Medicine: A "Hidden Curriculum?"

被引:20
作者
Johnston, William F. [1 ]
Rodriguez, Robert M. [2 ]
Suarez, David [3 ]
Fortman, Jonathan [2 ]
机构
[1] Hackensack Univ, Med Ctr, Dept Emergency Med, 30 Prospect Ave, Hackensack, NJ 07601 USA
[2] Univ Calif San Francisco, Dept Emergency Med, San Francisco, CA 94143 USA
[3] Kaiser Permanente Oakland Med Ctr, Dept Internal Med, Oakland, CA USA
关键词
Defensive medicine; Education; Malpractice; Medical education; Medicine;
D O I
10.5811/westjem.2013.8.19045
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Introduction: Defensive medicine is a medical practice in which health care providers' primary intent is to avoid criticism and lawsuits, rather than providing for patients' medical needs. The purpose of this study was to characterize medical students' exposure to defensive medicine during medical school rotations. Methods: We performed a cross- sectional survey study of medical students at the beginning of their third year. We gave students Likert scale questionnaires, and their responses were tabulated as a percent with 95% confidence interval (CI). Results: Of the 124 eligible third-year students, 102 (82%) responded. Most stated they rarely worried about being sued (85.3% [95% CI=77.1% to 90.9%]). A majority felt that faculty were concerned about malpractice (55.9% [95% CI=46.2% to 65.1%]), and a smaller percentage stated that faculty taught defensive medicine (32.4% [95% CI=24.1% to 41.9%]). Many students believed their satisfaction would be decreased by MC and lawsuits (51.0% [95% CI=41.4% to 60.5%]). Some believed their choice of medical specialty would be influenced by MC (21.6% [ 95% CI=14.7% to 30.5%]), and a modest number felt their enjoyment of learning medicine was lessened by MC (23.5% [95% CI=16.4% to 32.6%]). Finally, a minority of students worried about practicing and learning procedures because of MC (16.7% [95% CI=10.7% to 25.1%]). Conclusion: Although third-year medical students have little concern about being sued, they are exposed to malpractice concerns and taught considerable defensive medicine from faculty. Most students believe that fear of lawsuits will decrease their future enjoyment of medicine. However, less than a quarter of students felt their specialty choice would be influenced by malpractice worries and that malpractice concerns lessened their enjoyment of learning medicine.
引用
收藏
页码:293 / 298
页数:6
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