“I will prescribe regimen for the good of my patients according to my ability and my judgment and never do harm to anyone”- Hippocrates 1
Defensive medicine is an act of either commission or omission.2, 3 In this instance, the terms "commission" refer to the act of prescribing excessive amounts of medications (such as antibiotics, steroids, etc.), investigations (such as radiographs, blood tests, etc.), and procedures during the diagnosis or planning of a patient's treatment, as well as needless hospitalization. Omission is the act of not taking action and avoiding risky treatments (medically compromised patients, allergic etc.) on patients who could have benefited from them, or of referring to others if the patient's situation is critical. 3, 4 Although both commission and omission techniques deviate from standard dental procedures, they are sadly on the rise globally.5
Commission defensive practice has the potential to put patients in danger of health problems by ordering superfluous tests, especially if such tests are invasive or employ ionizing radiation. Additionally, it raises the price of healthcare. 6 Commission defensive practice also undermines the ethical and trust-based relationship between a doctor and a patient.
The legal climate in each nation about medical errors and liability is having an impact on medical practice, and it is probably the principal cause of the growth in defensive medicine. The goal of every dentist is typically to decrease the likelihood of litigation, therefore many dentists in India may have started practising defensive medicine to shield themselves from being sued for medical misconduct. Depending on their expertise, some practitioners claim that they changed their practices because they are concerned about being sued.7 In addition to the doctor's skill, several additional personal and societal variables can affect the outcome of the treatment. Therefore to confirm the existence of a mistake in medical practice, it is required to define the existence of professional fault.4 The insurance market for doctors can only provide protection against monetary damages; it cannot address the mental anguish that a doctor experiences or the loss of reputation, which takes years to establish.
To sum up, defensive medicine is not beneficial for patients or dentists. The negative impacts of defensive medicine extend beyond just rising healthcare costs and have an impact on the entire standard of the healthcare system.5, 6 The introduction of Cone Beam Computed Tomography (three-dimensional radiography) by unfolding many hidden details and Artificial Intelligence by analysing enormous datasets can aid in diagnostic and treatment planning accuracy in dentistry. Considering the nature of the dentist's work, which involves performing procedures on human bodies, justified legal protections, utilization of newer technologies along with up-to-date knowledge and skill can decrease the practice of defensive medicine and rebuild the relationship of trust between the dentist and the patients.
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