Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Defensive Medicine Practices Among Ophthalmologists in Turkey
Türkiye'deki Oftalmologlar Arasında Defansif Tıp Uygulamaları
Delil ÖZCANa, Abdurrahman Alpaslan ALKANb
aDepartment of Ophthalmology, University of Health Sciences Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, TURKEY
bClinic of Ophthalmology, Şehit Rıdvan Çevik State Hospital, Van, TURKEY
Turkiye Klinikleri J Ophthalmol. 2021;30(1):30-5
doi: 10.5336/ophthal.2020-76552
Article Language: EN
Full Text
ABSTRACT
 Objective: To investigate the prevalence of defensive medicine among ophthalmologists in Turkey and how malpractice cases affect ophthalmologists. Material and Methods: Surveys about defensive medicine were sent to the e-mail addresses of 247 ophthalmologists registered with the Turkish Ophthalmological Association between July 2019 and November 2019. In addition, direct interviews were conducted with the doctors between the same dates. Results: A total of 194 (78.5%) out of 247 ophthalmologists completed the survey. The survey results showed that, while most of the doctors had previously heard of defensive medicine, they did not have detailed knowledge about this concept and 66.5% of the ophthalmologists who responded want additional consultation for defensive purposes and 57.7% would like additional laboratory tests. In addition, 67.5% stated that they avoided cases that were difficult to diagnose and treat, while 68.6% stated that they avoided high-risk surgeries. Although only 6.2% of respondents had faced malpractice lawsuits, 78.7% of ophthalmologists stated that these cases affected their clinical practice. Conclusion: To the best of our knowledge, this is the first study investigating defensive medicine among ophthalmologists. Our results showed that defensive medicine is common in ophthalmology. In addition, malpractice cases increase defensive medicine among ophthalmologists and negatively affect their professional lives.

Keywords: Defensive medicine; malpractice; insurance, liability
ÖZET
 Amaç: Türkiye'deki oftalmologlar arasında defansif tıp uygulamalarının yaygınlığını ve malpraktis davalarının, oftalmologları nasıl etkilediğinin araştırılması. Gereç ve Yöntemler: Temmuz 2019 ve Kasım 2019 tarihleri arasında defansif tıp uygulamaları ile ilgili hazırlanmış anketler, 247 oftalmoloğun Türk Oftalmoloji Derneğine bildirdikleri elektronik posta adreslerine gönderildi. Ayrıca aynı tarihler arasında doktorlarla doğrudan görüşmeler yapılarak, anketlerin cevaplanması istendi. Bulgular: Anketin ulaştırıldığı 247 oftalmologdan 194 (%78,5)'ü anketi tamamladı. Anket sonuçları doktorların büyük bir kısmının defansif tıp kavramını daha önce duyduğunu fakat bu kavram hakkında detaylı bilgi sahibi olmadıklarını gösterdi. Anketi cevaplayan oftalmologların %66,5'i defansif amaçlarla ek konsültasyon istediklerini, %57,7'si ise ek laboratuar tetkikleri istediklerini belirtti. Ayrıca %67,5'i tanı ve tedavisi güç vakalardan, %68,6'sı ise yüksek riskli cerrahilerden kaçındıklarını belirtti. Anketi cevaplayanların yalnızca %6,2'si malpraktis nedeniyle dava edilmiş olmasına karşın oftalmologların %78,7'si, bu davaların klinik pratiklerini etkilediğini belirtti. Sonuç: Bildiğimiz kadarı ile bu çalışma, oftalmologlar arasında defansif tıbbın araştırıldığı literatürdeki ilk çalışmadır. Sonuçlarımız, oftalmoloji alanında da defansif tıbbın yaygın olduğunu göstermiştir. Ayrıca malpraktis davaları, oftalmologlar arasında defansif tıbbı yaygınlaştırmakta ve meslek hayatlarını olumsuz etkilemektedir.

Anahtar Kelimeler: Defansif tıp; malpraktis; sigorta, yükümlülük
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