Study on defensive medicine practices among obstetricians and gynecologists who provide breast care.

The purpose of this study was to assess malpractice concerns, career satisfaction, defensive medicine, experience with liability lawsuits, and changes in breast care practices among obstetricians and gynecologists (ob-gyns) who provide breast care. Four hundred ACOG Fellows were randomly selected and invited to participate, 247 (62%) responded. A majority of responders had increased the number of referrals for the diagnosis of breast abnormalities (58.9%) and treatment of breast disease (53.6%) due to fears and concerns regarding malpractice. On average, there was a high level of career satisfaction (M=8.5 [SD=2.5] on a scale from 0 to 10); however, those who had been sued were significantly less satisfied than those who had not. Physicians who had decreased breast surgical procedures and increased referrals for diagnosis and treatment of breast disease reported practicing defensive medicine more frequently. In a regression analysis, having been sued was a significant predictor of practicing defensive medicine more often. Physicians from states with malpractice crisis reported practicing defensive medicine more frequently and more lawsuits than physicians from stable states. Malpractice fears and defensive medicine continue to affect the practices of ob-gyns, most specifically, as this study shows, ob-gyns who provide breast care.