DEFENSIVE CLINICAL PRACTICE

1. DEFENSIVE CLINICAL PRACTICE Prof. M. Nabegh El-Mahallawi, MD, PhD Professor and Head of the Department of Ob/Gyn. Consultant Professor of Intercontinental OGASH Academy CSPP Ain Shams University. Cairo, Egypt CHAIRMAN OF EGYPT OGASH, EGOOS COORDINATOR, HONORARY ACADEMICIAN OF OGASH

2. DEFENSIVE CLINICAL PRACTICE • Defensive medicine is medical responses undertaken to avoid legal liability rather than to benefit the patient. Physicians may order tests, perform procedures, or avoid high-risk patients or high-risk surgery primarily to reduce their exposure to malpractice liability. This is self-serving practice for the physician. However, defensive medical practice could be utilized to improve health service and examples well be presented in the text. The proper clinical practice and decision making should consider legal liability but should benefit the patient than the physician. The aim should be "ideal medical practice" rather than defensive practice. • Actually physicians practice defensive medicine all the time. Some of us know it, acknowledge it, and accept it. Others believe this to be quite untrue and find the concept morally unconscionable. At traditional practice the conscientious practitioner would not otherwise take precautions as the yield of litigation is too low.

3. DEFENSIVE CLINICAL PRACTICE • Medical malpractice is considered an epidemic that continues to spread in Egypt. Members of the legal profession and patients should be warned that abuse of malpractice may retard patient safety. Public should be aware that there are many reasons for bad outcomes in medical practice not all of which are related to negligence by a health care provider. • The medical issues have become more complex, rulings in the courts and in the legislatures have extended beyond the simplistic questions. The profession will do well to review, remember, arid practice based on both ethical and clinical care standards. The law requires measures. The need for such measures stimulated the responsible medical authorities to develop guidelines and consensus forms for clinical practice that help medical profession at court. • Legal pitfalls of each topic in the clinical practice need to be learned and included at regular teaching and considered at the standard

4. DEFENSIVE CLINICAL PRACTICE • practice. Hospital administrative duties should include guidelines instructions based on the possible allegation. • The common causes of allegation in obstetrics and gynecology include; delay in diagnosis, anesthesia error, improper consent before a medical procedure, surgical error, failure to diagnose a medical condition, improper treatment of an illness or disease, birth injury, including cerebral palsy and brain damage, prescription drug error and negligence.

5. PRIZEWINNER OF HERA's GOLDEN PRIZE - 2007, PRIZEWINNER OF ERNST THEODOR RIPPMANN INTERNATIONAL PRIZE - 2007, PRIZEWINNER OF PROFESSOR IOSEB JORDANIA INTERNATIONAL PRIZE-2007

6. Thank you for your attention