Defensive medicine is a growing concern in modern healthcare, driven by physicians’ fear of litigation. It involves unnecessary tests and procedures and avoidance of high-risk treatments. These practices increase healthcare costs, limit patient access to necessary care, and negatively impact the physician–patient relationship. Additionally, defensive medicine contributes to physician stress and dissatisfaction, thereby potentially reducing the attractiveness of the medical profession.

This survey explores the prevalence of defensive medicine in Czech surgical departments through a survey conducted among 31 surgeons in two county hospitals.

The results confirm that all respondents engage in some form of defensive medical practice. Notably, 17% of radiological examinations were performed for assurance rather than medical necessity. A hypothetical case study demonstrated that knowledge of a patient’s history of litigation significantly increased the likelihood of additional defensively motivated tests.

Defensive medicine is a complex issue that requires cooperation between healthcare providers, legal professionals, policymakers, and medical organizations. We discuss different approaches to addressing defensive medicine. This includes the implementation of evidence-based clinical guidelines, improvements in physician–patient communication, and reforms in legal and regulatory frameworks.

The main novel aspect of this article is that it brings attention to a widely overlooked issue in surgical literature and also proposes potential solutions.