Küçük Mert
a Department of Obstetrics and Gynecology , Mugla Sitki Kocman University , Mugla , Turkey.
b Department of Medical Education and Bioinformatics , Mugla Sitki Kocman University , Mugla , Turkey.
J Obstet Gynaecol. 2018 Feb;38(2):200-205. doi: 10.1080/01443615.2017.1340933. Epub 2017 Sep 11.
In recent years, there has been a remarkable increase in medical malpractice litigations against OB/GYNs in Turkey and globally. This high litigation atmosphere may have changed attitudes, behaviour and practice of OB/GYNs. In the current study, opinions and attitudes of OB/GYNs regarding defensive medicine and to what extent they practice it were investigated. One hundred and eight OB/GYNs participated in the study. All participants found obstetrics and gynaecology riskier when compared with other medical branches and reported that they were increasingly practising defensive medicine. The majority of the OB/GYNs stated that they abstained from many risky interventions and expressed their belief that the high caesarean section (C-section) rate was associated with medico-legal concerns. The majority of the participants supported enacting of a specific medical malpractice law and supported the establishment of medically specialised courts. These regulations demanded by OB/GYNs should be taken into account by health authorities. Impact statement What is already known on this subject: In recent years, there has been a remarkable increase in medical malpractice litigations against OB/GYNs in Turkey and globally. Turkey has serious problems with the high C-section rate, which has been suggested to be related to medicolegal issues in a previous research. Fifty-one percent of babies, namely most of them, are delivered via C-section. There is no specific medical malpractice law and medically specialised court in Turkey. What the results of this study add: It seems like there is a professional liability crisis among OB/GYNs in Turkey. OB/GYNs reported that they were increasingly practising defensive medicine, and stated that they abstained from many risky interventions. A high C-section rate was found to be related to medicolegal concerns in OB/GYNs' perspective in the current study. OB/GYNs demanded some reasonable regulations. What the implications are of these findings for clinical practice and/or further research: Regulations demanded by OB/GYNs, which were probed in the current study, such as enacting a specific medical malpractice law and establishment of a medically specialised court, should be taken into account by health authorities in Turkey. The findings of the current study is believed to produce important results for the success of Health transformation programme put into practice in Turkey, which was not able to stop increasing C-section rates. Studies evaluating the direct or indirect costs related to defensive medicine practices of OB/GYNs in Turkey should be performed in subsequent research.
近年来，土耳其乃至全球针对妇产科医生的医疗事故诉讼显著增加。这种高诉讼氛围可能改变了妇产科医生的态度、行为和执业方式。在本研究中，调查了妇产科医生对防御性医疗的看法和态度以及他们在多大程度上实施防御性医疗。108名妇产科医生参与了该研究。所有参与者都认为与其他医学分支相比，妇产科风险更高，并报告称他们越来越多地实施防御性医疗。大多数妇产科医生表示他们避免了许多有风险的干预措施，并表示他们认为高剖宫产率与医疗法律问题有关。大多数参与者支持制定一部专门的医疗事故法，并支持设立医学专业法庭。卫生当局应考虑妇产科医生提出的这些规定。影响声明关于该主题已有的了解：近年来，土耳其乃至全球针对妇产科医生的医疗事故诉讼显著增加。土耳其剖宫产率居高不下，存在严重问题，先前的一项研究表明这可能与医疗法律问题有关。51%的婴儿，即大多数婴儿，通过剖宫产分娩。土耳其没有专门的医疗事故法和医学专业法庭。本研究的结果补充了什么：土耳其妇产科医生似乎面临职业责任危机。妇产科医生报告称他们越来越多地实施防御性医疗，并表示他们避免了许多有风险的干预措施。在本研究中，从妇产科医生的角度来看，高剖宫产率与医疗法律问题有关。妇产科医生要求一些合理的规定。这些发现对临床实践和/或进一步研究有何影响：本研究中调查的妇产科医生要求的规定，如制定一部专门的医疗事故法和设立医学专业法庭，土耳其卫生当局应予以考虑。本研究的结果被认为将为土耳其实施的未能阻止剖宫产率上升的健康转型计划的成功产生重要成果。后续研究应开展评估土耳其妇产科医生防御性医疗行为相关直接或间接成本的研究。
