General practitioners' perceptions of medicolegal risk - Using case scenarios to assess the potential impact of prostate cancer screening guidelines

Objective: To ascertain general practitioners' perceptions of medicolegal r isk when screening for prostate cancer, and explore the potential impact of three national guidelines on perceptions and clinical practice. Design: Postal survey in August 1997. Participants: 219 randomly selected GPs in New South Wales (65% response ra te). Main outcome measures: Response to case scenarios; perceptions of medicoleg al risk and protection afforded by national guidelines before and after rea ding extracts of three national guidelines; ratings of current and potentia l strategies to increase GPs' sense of medicolegal protection. Results: 90% (95% CI, 86.5%-94.3%) would screen an asymptomatic male patien t and 61% (95% CI, 54.2%-67.2%) indicated GPs would be at risk if they did not screen. Although significant changes in responses were found after resp ondents had read guideline extracts, 46% (95% CI, 39.5%-52.7%) continued to perceive medicolegal risk if screening was not performed. About two-thirds (65%; 95% CI, 59.9%-72.5%) supported a clear statement about the legal sta tus of guidelines in a court of law to increase their sense of medicolegal protection. Conclusions: Even when made aware of national evidence-based guidelines aga inst prostate cancer screening, GPs in our survey perceived limited hypothe tical medicolegal protection.