Defensive medicine—ordering tests, procedures, or referrals primarily to avoid litigation rather than to benefit the patient—has become increasingly common across healthcare settings. While often viewed as a protective response to medico-legal pressure, this practice raises important clinical, ethical, and economic concerns that affect everyday medical decision-making. From a clinician’s perspective, defensive strategies may provide short-term reassurance in high-risk or ambiguous cases.
However, excessive investigations and interventions can expose patients to unnecessary costs, procedural risks, overdiagnosis, and anxiety, while also contributing to resource strain and inefficiencies within healthcare systems. Evidence suggests that fear of litigation, lack of trust, time constraints, and poor communication are key drivers of defensive practice. Importantly, defensive medicine may…
