Awareness of quaternary prevention and defensive attitudes among family physicians

Objective: The aim of this study was to assess family physicians awareness of the concept of quaternary prevention and their attitudes towards defensive medicine. Materials and Methods: The populations of this descriptive study were family medicine residents and family physicians working in primary care. The authors developed a “Quaternary Prevention Awareness Form” based on the literature. A questionnaire consisting of socio-demographic questions and the Defensive Medicine Practices Attitude Scale was administered online and face-to-face. Results: The mean age of the 312 physicians was 39.22±9.55 years. Quaternary prevention had been heard of by 63.8% (n=199) of the physicians, but only 6.4% (n=20) had detailed knowledge of the concept. Although male physicians were more aware of “disease mongering” (p=0.003), females were more aware of “overtreatment” and “medical treatment management” (p=0.040; p=0.013, respectively). The results showed that males (p=0.007), residents (p=0.039) and those who had been sued for malpractice (p=0.004) had higher defensive medicine attitudes. Conclusion: This study shows the importance of physicians’ awareness and knowledge, which have been enhanced by specialisation, urban practice and training in quaternary prevention. In order to protect society from the harms of excessive medical practices, medical education needs to be reviewed to remind us of “primum non nocere”.