Steurer,J.
Held,U.
Schmidt,M.
Gigerenzer,G.
Tag,B.
Bachmann,L.M.

BACKGROUND: In the United States, lawsuits against physicians have had an impact on their behaviour, resulting in overdiagnosis and other forms of 'defensive medicine'. Does a similar situation exist in Switzerland? Using prostate-specific antigen (PSA) screening as an example, we surveyed Swiss physicians and assessed the extent to which liability fears influenced their recommendation for testing. METHODS: At a continuing medical education conference we distributed a pilot-tested questionnaire to 552 participants. Two hundred and fifty of them (45 \% ) completed the questionnaire. RESULTS: Of the participants, 158 (68 \% ) were general practitioners and 73 (32 \% ) specialists in internal medicine. Seventy-five per cent of both groups recommend regular PSA screening to men older than age 50. Yet only 56 \% of the general physicians and 53 \% of the internists believe that PSA measurement is an effective screening method. A substantial proportion of the physicians - 41 \% of general practitioners and 43 \% of internists - reported that they sometimes or often recommend this test for legal reasons. CONCLUSIONS: Defensive medicine is not a phenomenon particular to the USA, but is also observable in Switzerland. This result is surprising, given that in Switzerland and other European countries, a physician who does not recommend a test or treatment whose effectiveness is controversial need not fear litigation.

Steurer, J., Held, U., Schmidt, M., Gigerenzer, G., Tag, B., & Bachmann, L. M. (2009). Legal concerns trigger prostate-specific antigen testing. Journal of Evaluation in Clinical Practice, 15, 390-392. doi:10.1111/j.1365-2753.2008.01024.x (Full text)

Publication year	2009
Document type:	Article
Publication status:	Published
External URL:	http://library.mpib-berlin.mpg.de/ft/js/JS_Legal_2009.pdf View
Categories:	EmotionEducationHealthLaw
Keywords:	defensive medicinelegal aspectsprostate cancerscreening