Table 2.

Characteristics and types of defensive medicine behaviors reported in the included studies

Main Themes	Sub-themes	Samples codes
Assurance behaviors (not detrimental to patients)	• Prescribe unnecessary services	• Prescribing unnecessary medication or antibiotics’ • Request unnecessary laboratory tests and investigations • Request unnecessary imaging • Calling unnecessary examinations and consultations • Ordering more consultations on probable complications • Selecting the more extremist diagnosis for borderline cases
	• Unnecessary referral cases to other specialties and hospitals	• Refer patients to other specialists unnecessarily • Send patients to emergency room, in unnecessary conditions
	• Unnecessary cases admission and hospitalization	• Hospitalized patient who can be treated as an outpatient
	• Suggest and perform unnecessary invasive procedures	• Ordering unnecessary biopsies • Ordering unnecessary endoscopies
	• Spend more time with patients and their family	• Describe medical procedures to patients in more details • Request additional reviews • Increases follow-up • Initiates communication with family • More patients’ observations than required
Avoidance behaviors (detrimental to patients)	• Avoid applying effective high-risk procedures / interventions, and use non-invasive protocols	• Ceasing high-risk procedures • Avoid treatment protocols or guidelines with high complication
	• Avoiding to admit and care high-risk patients	• Withdraw from practice entirely and retire • Avoid patients with complex medical problems
	• Performed unnecessary intervention surgery	• Perform cardio-pulmonary resuscitations and intubations for poor prognosis patients • Caesarean section without indications • Excising skin lesions that are not suspected of being malignant
	• Avoiding switching to oral treatments	• Avoid stop parenteral drugs