Vol. 14 No. 2 (2021): A Year after the Pandemic

Practicing Defensive Medicine Benefits No one

Shailja Chaturvedi BSc, MBBS, FRANZCP
Australian Indian Medical Association, Penrith, NSW, Australia

Published 2021-06-05


  • defensive medicine,
  • medical litigation,
  • medical regulator

How to Cite

Chaturvedi, S. (2021). Practicing Defensive Medicine Benefits No one. Sushruta Journal of Health Policy & Opinion, 14(2), 1–4. https://doi.org/10.38192/14.2.5


Background: More doctors are practising defensive medicine, which may have an impact on patient care. This paper explores the consequences and reasons, for the widespread trend, and recommendations for patient-focused clinical care.

Objective: A malpractice suit is the most scarring ordeal that a physician can undergo emotionally and financially. Excessive investigations may be counterproductive. Avoiding certain procedures or patients, for the fear of adverse outcome can be hazardous. There is a need for a better, discerning and judicious system, to minimise the trauma to the largely conscientious and dedicated medical professionals.


How and when the term defensive medicine started, is difficult to trace. However, over the past few decades, it seems to be a well-known practice in industrialised countries. It may have been due to increasing complaints against doctors heralding potential litigation and malpractice suit. Most doctors do not take the privilege of the trust of their patients lightly and respond to it with utmost sincerity.


  1. Ford N. The elephant in the consulting room. Aust N Z J Psychiatry 2019;53:809–10. doi:10.1177/0004867419844600
  2. Complaints mechanism administered under the Health Practitioner Regulation National Law – Parliament of Australia. https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/ComplaintsMechanism (accessed 5 Jun 2021).
  3. Mental Health Declaration of Human Rights. Citizens Commission on Human Rights, CCHR — Nonprofit Mental Health Watchdog. 1AD.https://www.cchr.org/about-us/mental-health-declaration-of-human-rights.html (accessed 5 Jun 2021).
  4. Australia’s Star Chamber. Australian Medical Association (NSW). 2018.https://www.amansw.com.au/australias-star-chamber/ (accessed 5 Jun 2021).
  5. Finlay AJF, Stewart CL, Parker M. Open disclosure: ethical, professional and legal obligations, and the way forward for regulation. The Medical Journal of Australia 2013;198:445–8. doi:10.5694/mja12.10734
  6. Physician spending and subsequent risk of malpractice claims: observational study | The BMJ. https://www.bmj.com/content/351/bmj.h5516.long (accessed 5 Jun 2021).
  7. Perceived practice change in Australian doctors as a result of medicolegal concerns | The Medical Journal of Australia. https://www.mja.com.au/journal/2010/193/10/perceived-practice-change-australian-doctors-result-medicolegal-concerns (accessed 5 Jun 2021).
  8. Bismark MM, Spittal MJ, Plueckhahn TM, et al. Mandatory reports of concerns about the health, performance and conduct of health practitioners. The Medical Journal of Australia 2014;201:399–403. doi:10.5694/mja14.00210
  9. Dutheil F, Aubert C, Pereira B, et al. Suicide among physicians and health-care workers: A systematic review and meta-analysis. PLOS ONE 2019;14:e0226361. doi:10.1371/journal.pone.0226361
  10. Milner AJ, Maheen H, Bismark MM, et al. Suicide by health professionals: a retrospective mortality study in Australia, 2001–2012. The Medical Journal of Australia 2016;205:260–5. doi:10.5694/mja15.01044
  11. Casey D, Choong KA. Suicide whilst under GMC’s fitness to practise investigation: Were those deaths preventable? Journal of Forensic and Legal Medicine 2016;37:22–7. doi:10.1016/j.jflm.2015.10.002
  12. Wardle JL, Sibbritt D, Broom A, et al. Is Health Practitioner Regulation Keeping Pace with the Changing Practitioner and Health-Care Landscape? An Australian Perspective. Front Public Health 2016;4. doi:10.3389/fpubh.2016.00091
  13. Bawa-Garba case has left profession shaken and stirred | The BMJ. https://www.bmj.com/content/360/bmj.k456 (accessed 5 Jun 2021).
  14. The Bawa-Garba case | The BMJ. https://www.bmj.com/bawa-garba (accessed 21 Jan 2020).
  15. Singhal P, Pandya B. Beyond BAWA-GARBA: Sushruta Journal of Health Policy & Opinion 2018;11:20–1. doi:10.38192/11.1.8
  16. Understanding the stresses and strains of being a doctor | The Medical Journal of Australia. https://www.mja.com.au/journal/2004/181/7/understanding-stresses-and-strains-being-doctor (accessed 5 Jun 2021).
  17. Australian Psychiatrists Today: Proud of their Profession but Stressed and Apprehensive about the Future - Joseph M Rey, Garry Walter, Michael Giuffrida, 2004. https://journals.sagepub.com/doi/10.1080/j.1440-1614.2004.01320.x (accessed 5 Jun 2021).