Dataset Information

Defensive medicine among obstetricians and gynecologists in tertiary hospitals.

ABSTRACT:

Objective

To describe the daily work practice under the threat of defensive medicine among obstetricians and gynecologists.

Study design

A prospective cross-sectional survey of obstetricians and gynecologists working at tertiary medical centers in Israel.

Results

Among the 117 obstetricians and gynecologists who participated in the survey, representing 10% of the obstetricians and gynecologists registered by the Israel Medical Association, 113 (97%) felt that their daily work practice is influenced by concern about being sued for medical negligence and not only by genuine medical considerations. As a result, 102 (87%) physicians are more likely to offer the cesarean section option, even in the absence of a clear medical indication, 70 (60%) follow court rulings concerning medical practices, and 85 (73%) physicians mentioned that discussions about medical negligence court rulings are included in their departments' meetings.

Conclusions

Defensive medicine is a well-embedded phenomenon affecting the medical decision process of obstetricians and gynecologists.

SUBMITTER: Asher E

PROVIDER: S-EPMC3590209 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Publications

Defensive medicine among obstetricians and gynecologists in tertiary hospitals.

Asher Elad E Dvir Shay S Seidman Daniel S DS Greenberg-Dotan Sari S Kedem Alon A Sheizaf Boaz B Reuveni Haim H

PloS one 20130306 3

<h4>Objective</h4>To describe the daily work practice under the threat of defensive medicine among obstetricians and gynecologists.<h4>Study design</h4>A prospective cross-sectional survey of obstetricians and gynecologists working at tertiary medical centers in Israel.<h4>Results</h4>Among the 117 obstetricians and gynecologists who participated in the survey, representing 10% of the obstetricians and gynecologists registered by the Israel Medical Association, 113 (97%) felt that their daily wo ...[more]

PMID: 23483896

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Project description:BACKGROUND:A mismatch between the requirement and annual production of obstetricians and gynecologists (OBs-GYNs) was observed in Nepal. On top of that, recruitment and retention of OBs-GYNs is a pressing problem, especially in district hospitals of Nepal. In this connection, evidence on the job priorities and preferences of OBs-GYNs, which is currently lacking in Nepal, would help in policymakers in devising recruitment and retention strategies in these hospitals. This study, therefore, aims at exploring the most relevant job attributes that OBs-GYNs would prefer to work in the district hospitals of Nepal using a discrete choice experiment (DCE) technique. METHODS:Job attributes relevant to design the questionnaire were identified using keyinformant interviews and focusgroup discussions with policymakers and top managers. Then, 48 choice sets were developed using a fractional factorial design. Using these unlabeled choice sets, a DCE was conducted among 189 OBs-GYNs. The multinomial logistic regression model was used to estimate the marginal utilities and other model parameters. The willingness to pay/accept estimates was also measured for each job attribute. RESULTS:OBs-GYNs preferred the presence of a full team at the workplace (OB-GYN, pediatrician, and anesthesiologist), provision of primary and secondary education for children, and opportunity of private practice. On the other hand, a few job attributes such as a higher duration of service in district hospitalsand the provisions of a car allowance were preferred less by the respondents. Results from the marginal utility by the OBs-GYNs would be open to trade among the attributes. CONCLUSIONS:The job attributes identified as incentives in this study should be included in a package to attract OBs-GYNs to serve in district hospitals of Nepal rather than offering a standard incentive package to all health workers. Similarly, this study confirmed the importance of the combination of non-monetary and monetary interventions in attracting and retaining health workers in district hospitals of Nepal.

Project description:The successful management of a childbirth emergency will be dependent on the decision-making of involved obstetricians and gynecologists. Individual differences in decision-making may be explained through personality traits. The objectives of the present study were (I) to describe personality trait levels of obstetricians and gynecologists and (II) to examine the relationship between obstetricians' and gynecologists' personality traits and decision-making styles (Individual, Team and Flow) in childbirth emergencies; also controlling for cognitive ability (ICAR-3), age, sex and years of clinical experience. Obstetricians and gynecologists, members of the Swedish Society for Obstetrics and Gynecology (N = 472) responded to an online questionnaire that included a simplified version of the Five Factor Model of personality (IPIP-NEO), and 15 questions concerning childbirth emergencies based on a model of decision-making styles (Individual, Team and Flow). The data was analyzed using Pearson's correlation analysis and multiple linear regression. Swedish obstetricians and gynecologists scored (P < 0.001) lower on Neuroticism (Cohen's d = - 1.09) and higher on Extraversion (d = 0.79), Agreeableness (d = 1.04) and Conscientiousness (d = 0.97) compared to the general population. The most important trait was Neuroticism, which correlated with the decision-making styles Individual (r = - 0.28) and Team (r = 0.15), while for example Openness only trivially correlated with Flow. Multiple linear regression showed that personality traits with covariates explained up to 18% of decision-making styles. Obstetricians and gynecologists have notably more distinct personality levels than the general population, and their personality traits relate to decision-making in childbirth emergencies. The assessment of medical errors in childbirth emergencies and prevention through individualized training should take account of these findings.

Dataset Information

Defensive medicine among obstetricians and gynecologists in tertiary hospitals.

Objective

Study design

Results

Conclusions

Publications

Defensive medicine among obstetricians and gynecologists in tertiary hospitals.

Similar Datasets

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