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Steurer, Johan; Held, Ulrike; Schmidt, Mathias; Gigerenzer, Gerd; Tag, Brigitte; Bachmann, Lucas M (2009). Legal concerns trigger prostate-specific antigen testing. Journal of Evaluation in Clinical Practice, 15(2):390-392.

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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.


9 citations in Web of Science®
12 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic and Policlinic for Internal Medicine
02 Faculty of Law > Institute of Legal Sciences > Criminal Law
Dewey Decimal Classification:340 Law
610 Medicine & health
Date:August 2009
Deposited On:18 Feb 2010 12:49
Last Modified:05 Apr 2016 13:58
Publisher DOI:10.1111/j.1365-2753.2008.01024.x
Related URLs:http://opac.nebis.ch/F/?local_base=NEBIS&con_lng=GER&func=find-b&find_code=SYS&request=004354321
PubMed ID:19335502

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