Growing threat of complaints has led four in five GPs to practice 'defensive medicine' that risks over-diagnosis and medicalisation

By SHAUN WOOLLER, EXECUTIVE HEALTH EDITOR Published: 00:01, 10 June 2026 | Updated: 00:06, 10 June 2026 The growing threat of complaints has led four in five GPs to practice ‘defensive medicine’ that risks over-diagnosis and medicalisation, a survey reveals. Family doctors said they are more inclined to prescribe certain medicines, refer patients to specialists or spend longer writing notes to prevent a backlash. The excessive caution comes amid fears of missing a serious condition that could result in a legal complaint or a referral to the doctors’ regulator. But it often involves deviating from standard practice, with GPs prescribing extra drugs and ordering more tests that may increase patient anxiety and place additional burden on the health service in terms of costs and demand for appointments. Some 78 per cent of family doctors agreed the threat of complaints had led them to practice more defensively than they feel is best for their patient. Just 9 per cent disagreed, according to the poll of 836 GPs by trade magazine Pulse. One family doctor said: ‘I have found myself practising more defensive medicine at times, perhaps investigating or referring where previously I might have watched and waited. ‘Despite time constraints, I find myself writing essays in patient notes to make sure I’ve covered my own back, safety-netted clearly. The excessive caution comes amid fears of missing a serious condition that could result in a legal complaint or a referral to the doctors’ regulator. ‘This, combined with patient attitudes, has made working in the NHS almost untenable in the current climate.’ Figures from NHS Resolution, which handles compensation claims on behalf on the health service, show it is dealing with around 3,000 cases a year involving GPs - some up worth more than £4million. Meanwhile, figures from NHS England and the General Medical Council also reveal a rise in complaints about family doctors and their care. One doctor described general practice as a ‘very high-risk environment’ and said ‘the only way to navigate this is to act and practise defensively and have a low threshold of risk’. ‘Otherwise, almost certainly something will come back to bite you,’ they added. Previous research published in the British Medical Journal found a strong link between defensive medicine and burnout, suggesting doctors engaged in such practice are more stressed. Dennis Reed, director of Silver Voices, which campaigns on behalf of elderly patients, said: ‘I do feel sorry for GPs in this regard as they do risk a frenzy of litigation if they miss something. ‘It seems they are damned for sending people for tests and damned if they don’t. Dennis Reed, director of Silver Voices, said patients want their doctor to 'play it safe' and send them for checks if they have concerns. ‘However, I think most patients would rather see their doctor play it safe and send them for additional checks if they have any concerns - it’s best to cover all angles as the consequences of not acting could be serious. ‘In the past, there was a tendency for GPs to overreach for their prescription pad and dole out drugs just to get patients out the door. ‘Now, patients know there are so many tests and scans available, they want to access them - and I can understand why.’ The poll features in a new report into complaints and regulation, produced by Cogora, the publisher of Pulse, and funded by Medical Protection, which offers indemnity services to GPs. Dr Sarah Townley, deputy medical director at Medical Protection, said: ‘We know our members feel a growing sense of pressure. ‘They're worried about all sorts of medicolegal issues - complaints, claims, even police investigations - it's definitely at the back of their minds. ‘There are multiple factors that can lead to defensive medicine. ‘A lot of it is about fear of consequences. Now, that might be linked to complaints, it might be fear of the regulator, it might be fear of the patient being unhappy. The wider culture where doctors feel they're being publicly criticised, may also be a factor.’ No comments have so far been submitted. Why not be the first to send us your thoughts, or debate this issue live on our message boards. By posting your comment you agree to our house rules. Do you want to automatically post your MailOnline comments to your Facebook Timeline? Your comment will be posted to MailOnline as usual. 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