Nearly eight out of ten general practitioners are admitting to altering their medical practices and deviating from standard care to avoid patient complaints or regulatory referrals, a new survey reveals.
Family doctors reported a greater inclination to prescribe certain medications, refer patients, or dedicate more time to writing notes, all to prevent potential backlash.
This approach, termed “defensive medicine,” carries risks, potentially leading to overdiagnosis and leaving patients feeling needlessly anxious.
A Pulse survey of 836 GPs found that 78% agreed the threat of complaints had led them to practise more defensively than they felt was truly best for their patients.
One family doctors told Pulse: “I have found myself practising more defensive medicine at times, perhaps investigating or referring where previously I might have watched and waited.
“Despite time constraints, I find myself writing essays in patient notes to make sure I’ve covered my own back, safety-netted clearly.
“This, combined with patient attitudes, has made working in the NHS almost untenable in the current climate.”
Figures from NHS Resolution show it is dealing with around 3,000 cases a year involving GPs.
One doctor described general practice as a “very high-risk environment” and said “the only way to navigate this is to act and practise defensively and have a low threshold of risk”.
“Otherwise, almost certainly something will come back to bite you,” they added.
The poll forms part of a new report being launched at Pulse Live in Birmingham on June 10, which is supported by Medical Protection.
Dr Sarah Townley, deputy medical director at Medical Protection, said: “We know our members feel a growing sense of pressure.
“They’re worried about all sorts of medicolegal issues – complaints, claims, even police investigations – it’s definitely at the back of their minds.”
It comes after a new report highlighted how GPs are failing to identify older patients at risk of falls and medication errors as they grapple with an “overload” of new priorities set by NHS England.
The report highlights how the health service has been “hyper-focused” on improving access to family doctors, including the implementation of new technology.
However, the Public Accounts Committee (PAC) has issued a stark warning, stating that any success must not come “by a system turning its face away from older people.”
GPs are contractually obliged to support frail individuals, conducting clinical reviews that encompass medication evaluations and falls risk assessments.
Despite this, the PAC found that in 2024/25, only 17% of patients aged 65 or over were assessed for frailty.
Furthermore, of the 226,000 people diagnosed with severe frailty during this period, a mere 16% received a medication review, and just 18% had a falls risk assessment.
The PAC report condemned this as “not acceptable care,” warning that it leaves vulnerable patients more susceptible to falls and subsequently more likely to require urgent and costly hospital treatment.
