Primary Care Physicians' Anxiety About Medical Errors and Attitudes Towards Defensive Medicine

Objective: This study aimed to evaluate the relationship between family physicians' anxiety about medical errors and their attitudes towards defensive medicine by measuring their malpractice fear and defensive medicine behaviors. Method: This descriptive study included 395 family physicians working in family health centers in İstanbul/Türkiye. The study's data was collected via an online questionnaire, which included 58 items. The questionnaire included four sections: a sociodemographic form, Malpractice Knowledge Level Form, Malpractice Fear Scale, and Defensive Medicine Behavior Scale. Spearman’s correlation coefficient and Mann-Whitney U, chi-square, and Fisher’s exact tests were used in data analysis. p<0.05 was considered a statistically significant level. Results: Of the physicians, the mean age was 38.07 years (SD=8.42 years), and 55.6% (n=219) were female. The mean duration of working as a physician was 7.38 years (SD=4.40 years), ranging from 1 to 38 years. The proportion of participants who complained due to malpractice was 12.2%, and 28.4% had received education on medical errors. The proportion of physicians with a high level of malpractice fear was 74.4%. The mean correct response rate on the Malpractice Knowledge Level Form was 69.44 (SD=13.21), with 62.9% having a sufficient knowledge level. Low-level but statistically significant negative correlations were found between increasing age and defensive medicine attitudes and malpractice fears (p<0.05 for all). Also, moderate and high levels of positive correlations were found between defensive medicine practice scores and malpractice fear scores (p<0.05 for all). Conclusion: The study showed that increased fear of medical errors causes defensive medicine attitudes among family physicians. As both malpractice fear and defensive medicine practices decrease with increasing age, young physicians should receive education to foster better patient communication without anxiety. Legal reforms and health policies that reduce the pressure physicians feel from medical error anxiety are necessary.