Nature, Characteristics, and Reported Experiences of Medical Malpractice Disputes Among Egyptian Physicians Practicing in Egypt and Other Arab Countries: A Cross-Sectional Medicolegal Analysis of Psychological Distress, Somatic Symptoms, and Defensive Behavior

AI Summary

Lawsuits were the most serious dispute for 51.4% of physicians; management-related allegations were most common (59.4%), with practice in Egypt linked to procedure-related claims.
Malpractice disputes were associated with high psychological and somatic burden: 62.3% had severe distress; frequent PTSD symptoms and sleep disturbance affected 81.2%.
Defensive medicine was widespread, with 92% reporting high or very high defensive behaviour, prompting calls for medicolegal education, clearer pathways, documentation, and peer support.

TL;DR (AI Generated)

This study characterizes the medicolegal profile of malpractice disputes among Egyptian physicians practicing in Egypt and other Arab countries and examines how these disputes correlate with concurrent psychological, somatic, and defensive behavioral burdens.

Methods: A cross-sectional online survey with nonprobability sampling was conducted from March to December 2025 among 586 practicing Egyptian physicians involved in at least one malpractice dispute.

Participants completed the Kessler Psychological Distress Scale-6, the Impact of Event Scale-6, twelve items of the Defensive Medicine Behavior Scale, two items of the Malpractice Fear Scale, and a self-reported somatic symptom checklist.

Basic summary

Healthcare (Basel). 2026 Oct 28;14(21):3657. doi: 10.3390/healthcare14213657.

ABSTRACT

Background/Objectives: Medical malpractice disputes may affect physicians’ well-being and clinical behavior. This study characterizes the medicolegal profile of malpractice disputes among Egyptian physicians practicing in Egypt and other Arab countries and examines how these disputes correlate with concurrent psychological, somatic, and defensive behavioral burdens. Methods: A cross-sectional online survey with nonprobability sampling was conducted from March to December 2025 among 586 practicing Egyptian physicians involved in at least one malpractice dispute. Participants completed the Kessler Psychological Distress Scale-6, the Impact of Event Scale-6, twelve items of the Defensive Medicine Behavior Scale, two items of the Malpractice Fear Scale, and a self-reported somatic symptom checklist. Multivariable regression identified independent correlates. Results: A lawsuit was the most serious dispute type for 51.4% of physicians, and management-related allegations were the most common (59.4%). Practice in Egypt rather than another Arab country was associated with procedure-related allegations (adjusted odds ratio 2.27; 95% confidence interval 1.49-3.45). Among resolved disputes, formal complaints (0.30; 0.18-0.49) and threats (0.45; 0.23-0.90) were less likely than lawsuits to end unfavorably for the physician. Recalling the dispute period, 62.3% had Kessler distress scores of 13 or more (mean 15.5 ± 6.4), with frequent post-traumatic stress symptoms (mean item score 2.7 ± 0.9) and somatic symptoms led by sleep disturbance (81.2%). High or very high defensive medicine scores were found in 92.0%. Conclusions: In this self-selected sample, malpractice disputes were associated with a heavy psychological, somatic, and behavioral burden. Medicolegal education, clearer complaint pathways, better documentation systems, and visible institutional peer support are policy considerations that need prospective evaluation.

PMID:43028680 | DOI:10.3390/healthcare14213657

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