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The attitudes towards defensive medicine among physicians of obstetrics and gynaecology in China: a questionnaire survey in a national congress.

ABSTRACT: OBJECTIVE:The study aimed to determine prevalence, patterns and risk factors of defensive medicine by obstetricians and gynaecologists across China. DESIGN:This is a questionnaire survey by written and on-line interview for participants. PARTICIPANTS:Among 1804 registered physicians participating at the 2017 Congress of Chinese Obstetricians and Gynecologists Association in Chengdu City, Sichuan Province, China, from 17 to 20 August 2017, 1486 participants (82.4%) responded the survey. MAIN OUTCOME MEASURES:Participants' strongly disagreed/disagreed and strongly agreed/agreed options were compared to determine specific factors contributing to their preferences towards defensive medicine. RESULTS:In the whole cohort of 1486 participants, 903/1486 (60.8%), 283/1486 (19.0%) and 170/283 (60.1%) participants had experienced at least one medical dispute, lawsuit or loss of a lawsuit, respectively; and 1284 (86.4%) participants had witnessed their colleagues exposed to medical disputes, lawsuits or loss of a lawsuit. Generally, 62.9% of the participants strongly agreed or agreed with defensive medicine. Gender, administration duty, employment hospital, education status, subspecialty, exposure to any medical disputes, lawsuits or loss of a lawsuit, and colleagues' experiences were independent risk factors relevant to participants' preferences about defensive medicine in a multivariate model. Participants were more prone to accept or endorse defensive medicine if they were female physicians; without administrative duties; working in non-tertiary hospitals; with an undergraduate degree; with any exposure to medical disputes, lawsuits or loss of a lawsuit; or having witnessed colleagues' similar experiences. CONCLUSIONS:About two-thirds of Chinese physicians practising obstetrics and gynaecology in our survey agreed with the practice of defensive medicine, but they had diverse preferences and understanding of specific practices, harms of defensive medicine and physician's roles.

SUBMITTER: Zhu L

PROVIDER: S-EPMC5829918 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND:China has witnessed a surge in violence against medical personnel, including widely reported incidents of violent abuse, riots, attacks, and protests in hospitals, but little is known about the impact of gender differences on the workplace violence against physicians of obstetrics and gynecology. The aim of this study was to analyse gender differences in workplace violence against physicians of obstetrics and gynecology in China. METHODS:Printed questionnaires were sent to participants of a national congress of obstetricians and gynecologists. The questionnaire consisted of items relevant to epidemiologic characteristics, workplace violence experienced in the past 12 months, participants' attitudes toward violence and physician-patient relationship. Data from female and male physicians were compared in univariate and multivariate analyses. RESULTS:We sent out 1,425 questionnaires, and 1,300 (91.2%) physicians responded. Among 1,247 participants with specified gender, female and male physicians consisted of 162 (13.0%) and 1,085 (87.0%), respectively. Over the past 12 months, about two-thirds of these physicians suffered verbal abuse in the workplace, gender difference aside. After adjustment for education status, working hospital and subspecialty, male physicians had suffered more physical assaults than female colleagues (18.8% vs. 10.5%, adjusted odds ratio [OR] 2.3, 95% confidence interval [CI], 1.4-3.7), most attacks without apparent physical injuries (adjusted OR 2.3, 95% CI, 1.4-3.7). Male physicians also suffered more sexual assaults than female colleagues (5.0% vs. 1.3%, adjusted OR 4.8, 95% CI, 1.8-13.3), nearly all of verbal harassment. There were only two sexual attacks on female physicians, and no rapes occurred. Although almost all physicians regarded the current circumstance as "unhealthy and stressful", more than half of them would take various active initiatives to create and maintain healthy and friendly physician-patient relationships. CONCLUSION:Male physicians of obstetrics and gynecology in China suffered the same number of verbal abuse incidents but more physical and sexual assaults than their female colleagues. Both genders had similar opinions about causes, consequences and management about work violence against physicians, and had the same pessimistic perspectives but innovative wishes for the physician-patient relationship.

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The attitudes towards defensive medicine among physicians of obstetrics and gynaecology in China: a questionnaire survey in a national congress.

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