{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:19:03Z","timestamp":1792757943758,"version":"4.5.0"},"reference-count":68,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T00:00:00Z","timestamp":1721088000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T00:00:00Z","timestamp":1721088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Philos Ethics Humanit Med"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This paper draws on qualitative research using focus groups involving 38 general practitioners (GPs). It explores their attitudes and feelings about (over-)medicalisation. Our main findings were that GPs had a complex representation of (over-)medicalisation, composed of many professional, social, technological, economic and relational issues. This representation led GPs to feel uncomfortable. They felt pressure from all sides, which led them to question their social roles and responsibilities. We identified four main GP-driven proposals to deal with (over-)medicalisation: (1) focusing on the communication in doctor\u2013patient relationships; (2) grounding practices in evidence-based medicine; (3) relying on clinical skills, experience and intuition; and (4) promoting training, leadership bodies and social movements. Drawing on these proposals, we identify and discuss five paradigms that underpin GPs\u2019 attitudes toward (over-)medicalisation: underlying social factors, preventing medicalisation, managing uncertainties, sharing medical decision-making and thinking about care as a rationale. We suggest that these paradigms constitute a defensive posture against GPs\u2019 uncomfortable feelings. All five defensive paradigms were identified in our focus groups, echoing contemporary political debates on public health. This non-exhaustive framework forms the outline of what we call <jats:italic>ordinary defensive medicine<\/jats:italic>. GPs\u2019 uncomfortable feelings are the origin of their defensive solutions and the manifestation of their vulnerability. This professional vulnerability can be shared with the patient\u2019s vulnerability. In our view, this creates an opportunity to rediscover patient\u2013doctor relationships and examine patients\u2019 and doctors\u2019 vulnerabilities together.<\/jats:p><jats:p>\u201cThere are many cases in which\u2014though the signs of a confusion of tongues between the patient and his doctor are painfully present\u2014there is apparently no open controversy. Some of these cases demonstrate the working of two other, often interlinked, factors. One is the patient\u2019s increasing anxiety and despair, resulting in more and more fervently clamouring demands for help. Often the doctor\u2019s response is guilt feelings and despair that his most conscientious, most carefully devised examinations do not seem to throw real light on the patient\u2019s \u201cillness\u201d, that his most erudite, most modern, most circumspect therapy does not bring real relief.\u201d (Balint M. The Doctor, His Patient and the Illness. New York: International Universities; 2005. [1957].)<\/jats:p><jats:p>\u201cTheories about care put an unprecedented emphasis on vulnerability\u2014taking up that challenge to transform what really counts in today\u2019s hospitals implies letting colleagues inside previously closely guarded professional boundaries\u201d (2, our translation).<\/jats:p>","DOI":"10.1186\/s13010-024-00160-0","type":"journal-article","created":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T07:02:04Z","timestamp":1721113324000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Ordinary defensive medicine: in the shadows of general practitioners\u2019 postures toward (over-)medicalisation"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5076-4226","authenticated-orcid":false,"given":"Micha\u00ebl","family":"Cordey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Chatelard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0207-0136","authenticated-orcid":false,"given":"Daniel","family":"Widmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7148-3922","authenticated-orcid":false,"given":"Patrick","family":"Ouvrard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0025-3449","authenticated-orcid":false,"given":"Lilli","family":"Herzig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,16]]},"reference":[{"issue":"1","key":"160_CR1","doi-asserted-by":"publisher","first-page":"122","DOI":"10.4103\/0973-1229.91587","volume":"10","author":"A Maturo","year":"2012","unstructured":"Maturo A, Medicalization. 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