Abstract:
OBJECTIVES:(a) To investigate defensive medical practices among general practitioners; (b) to compare any such practices with general practitioners' understanding of certain aspects of the terms of service and medical negligence and practitioners' concerns about the risk of being sued or having a complaint lodged. DESIGN:Postal questionnaire survey. Each questionnaire was followed by a reminder. SUBJECTS:500 systematically selected general practitioners on the membership list of the Medical Defence Union. MAIN OUTCOME MEASURES:Answers to questions on defensive medical practices, understanding of certain aspects of the terms of service and medical negligence, and concerns about the risk of being sued or having a complaint lodged. RESULTS:300 general practitioners returned the questionnaire (response rate 60%). 294 (98%) claimed to have made some practice changes as a result of the possibility of a patient complaining. Of the defensive medical practices adopted, the most common (over half of doctors stating likely or very likely) seemed to be increased diagnostic testing, increased referrals, increased follow up, and more detailed patient explanations and note taking. Respondents practised defensive medicine as a possible consequence of concerns about the risks of being sued or having a complaint lodged. This association was particularly strong for negative defensive practices. Defensive medical practice did not correlate with any misunderstanding about the law of negligence or the general practitioners' terms of service. CONCLUSIONS:General practitioners are practising defensive medicine. Some defensive practices such as increased patient explanations or more detailed note taking are clearly beneficial. However, implementing the findings of the Wilson report may increase negative defensive medical practices.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Summerton Ndoi
10.1136/bmj.310.6971.27subject
Has Abstractpub_date
1995-01-07 00:00:00pages
27-9issue
6971eissn
0959-8138issn
1756-1833journal_volume
310pub_type
杂志文章abstract:OBJECTIVE:To determine the outcome of administration of neuroleptics to patients with senile dementia of Lewy body type confirmed at necropsy. DESIGN:Retrospective analysis of clinical notes blind to neuropathological diagnosis. SETTING:Specialist psychogeriatric assessment units referring cases for necropsy to a tea...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6855.673
更新日期:1992-09-19 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of emotionalism after stroke, to assess its relation with other mood disorders, and to identify clinical variables with which it is associated. DESIGN:Descriptive study of a cohort of patients consecutively entered on a community stroke register. SETTING:Community based research p...
journal_title:BMJ (Clinical research ed.)
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更新日期:1989-04-15 00:00:00
abstract:OBJECTIVE:To examine associations between varenicline and the incidence of a range of adverse outcomes. DESIGN:Population based cohort study using within person analyses to control for confounding by indication. SETTING:Whole population of Sweden. PARTICIPANTS:7,917,436 people aged 15 and over, of whom 69,757 were t...
journal_title:BMJ (Clinical research ed.)
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更新日期:2015-06-02 00:00:00
abstract:OBJECTIVES:To identify risk factors predisposing to the development of flucloxacillin associated jaundice. DESIGN:Case-control study. Medical records of cases and controls were reviewed and information recorded on standard data collection forms. SETTING:Alfred Hospital recruiting subjects from Melbourne, Sydney, and ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6872.233
更新日期:1993-01-23 00:00:00
abstract:OBJECTIVES:To measure, in a service setting, the effect of magnetic resonance imaging on diagnosis, diagnostic certainty, and patient management in the neurosciences; to measure the cost per patient scanned; to estimate the marginal cost of imaging and compare this with its diagnostic impact; to measure changes in pati...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.303.6815.1435
更新日期:1991-12-07 00:00:00
abstract:OBJECTIVE:To examine the distribution of patterns of macronutrient density in relation to obesity. DESIGN:Cross sectional. SETTING:Denmark. SUBJECTS:323 men and women aged 35-65 years, selected randomly from a larger population sample of Danish adults. MAIN OUTCOME MEASURE:Bias in dietary reporting of energy and pr...
journal_title:BMJ (Clinical research ed.)
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doi:10.1136/bmj.311.7011.986
更新日期:1995-10-14 00:00:00
abstract:OBJECTIVE:To assess the effects of social deprivation on survival after cardiac surgery and to examine the influence of potentially modifiable risk factors. DESIGN:Analysis of prospectively collected data. Prognostic models used to examine the additional effect of social deprivation on the end points. SETTING:Birming...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.b902
更新日期:2009-04-02 00:00:00
abstract:OBJECTIVE:To investigate estimation of calorie (energy) content of meals from fast food restaurants in adults, adolescents, and school age children. DESIGN:Cross sectional study of repeated visits to fast food restaurant chains. SETTING:89 fast food restaurants in four cities in New England, United States: McDonald's...
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doi:10.1136/bmj.f2907
更新日期:2013-05-23 00:00:00
abstract:OBJECTIVE:To identify the number of patients who were misdiagnosed as being in the vegetative state and their characteristics. DESIGN:Retrospective study of the clinical records of the medical, occupational therapy, and clinical psychology departments. SETTING:20 bed unit specialising in the rehabilitation of patient...
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更新日期:1996-07-06 00:00:00
abstract:OBJECTIVES:To examine trends over time in the rates of admission to hospital for accidents of preschool children and to study patterns of repeated admissions for accidents in these children. DESIGN:Analysis of linked, routine abstracts of hospital inpatient records for accidents. SETTING:Six districts in the Oxford R...
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doi:10.1136/bmj.302.6767.16
更新日期:1991-01-05 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.306.6880.762
更新日期:1993-03-20 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.309.6947.79
更新日期:1994-07-09 00:00:00
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doi:10.1136/bmj.325.7374.1218
更新日期:2002-11-23 00:00:00
abstract:OBJECTIVE:To examine the effectiveness of parenteral corticosteroids for the relief of acute severe migraine headache and prevention of recurrent headaches. DESIGN:Meta-analysis. DATA SOURCES:Electronic databases (Cochrane Central Register of Controlled Trials, Medline, Embase, LILACS, and CINAHL), conference proceed...
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pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.39566.806725.BE
更新日期:2008-06-14 00:00:00
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doi:10.1136/bmj.k4388
更新日期:2018-11-06 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.38041.724421.55
更新日期:2004-03-27 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.316.7147.1796
更新日期:1998-06-13 00:00:00
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pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.e1454
更新日期:2012-03-15 00:00:00
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doi:10.1136/bmj.d8009
更新日期:2011-01-04 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.m1309
更新日期:2020-05-13 00:00:00
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doi:10.1136/bmj.313.7065.1119
更新日期:1996-11-02 00:00:00
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更新日期:1997-01-25 00:00:00
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更新日期:1992-03-28 00:00:00
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doi:10.1136/bmj.j413
更新日期:2017-02-13 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7023.97
更新日期:1996-01-13 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.330.7495.825
更新日期:2005-04-09 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.306.6874.357
更新日期:1993-02-06 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.38121.684410.AE
更新日期:2004-07-17 00:00:00
abstract:OBJECTIVE:To evaluate risk of late life coronary heart disease associated with being overweight in late middle or old age and to assess whether weight change modifies this risk. DESIGN:Longitudinal study of subjects in the epidemiological follow up study of the national health and nutrition examination survey I. SETT...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7097.1791
更新日期:1997-06-21 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of a brief cognitive behavioural intervention in reducing the incidence of sexually transmitted infections among gay men. DESIGN:Randomised controlled trial with 12 months' follow up. SETTING:Sexual health clinic in London. PARTICIPANTS:343 gay men with an acute sexually tran...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.322.7300.1451
更新日期:2001-06-16 00:00:00