title: Defensive medicine practices among gastroenterologists in Lombardy: between lawsuits and the economic crisis.
abstract: BACKGROUND
  Defensive medicine is becoming more frequent behaviour and has an impact on the economic 'health' of national healthcare systems.
  
  
  OBJECTIVE
  The aim of this study was to clarify the impact of defensive medicine on gastroenterological practices in Lombardy.
  
  
  METHODS
  Gastroenterologists attending the Lombardy Annual Gastroenterological Conference received a questionnaire based on multiple choice tests and visual analogue scales. The questionnaire was divided into three parts evaluating the respondent's characteristics, the number of procedures prescribed, and the percentage of those performed with a defensive purpose.
  
  
  RESULTS
  Sixty-four of 107 participants (60%) completed the questionnaire, 94% of whom reported practising defensive medicine. The percentage of defensively requested procedures amounted to 18% of all digestive endoscopies, 8.9% of abdominal ultrasonography scans, 4.9% of abdominal computed tomography or magnetic resonance scans, and 12.2% of all consultations. The total number of defensive procedures prescribed per month by the participants was 878, and 31.7% of the performed procedures (n=4897) were reported to defensively based. On the basis of the 2012 regional reimbursement fees, the yearly cost of defensive procedures prescribed and/or performed by all gastroenterologists in Lombardy was estimated to be € 8,637,835.
  
  
  CONCLUSIONS
  Our findings indicate that defensive medicine profoundly affects current medical practices among gastroenterologists, and has a considerable economic impact.
authors: Gastroenterology Unit 2, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy. lucelli@yahoo.com
authors: Luca
authors: L
authors: Elli
authors: Andrea
authors: A
authors: Tenca
authors: Marco
authors: M
authors: Soncini
authors: Giancarlo
authors: G
authors: Spinzi
authors: Elisabetta
authors: E
authors: Buscarini
authors: Dario
authors: D
authors: Conte
mesh_terms: D000328:Adult; D003675:Defensive Medicine / Q000191:economics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D003952:Diagnostic Imaging / Q000191:economics / Q000706:statistics & numerical data; D004470:Economics, Medical; D005260:Female; D005762:Gastroenterology / Q000191:economics* / Q000331:legislation & jurisprudence*; D006801:Humans; D007558:Italy; D016365:Liability, Legal; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires