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Cited by 386Patient Safety and Medication ErrorsMedical Malpractice and Liability IssuesHealthcare Quality and Management

Beyond Blame: Cultural Barriers to Medical Incident Reporting

Waring, Justin J.·2005·Social Science & Medicine
DOI 10.1016/j.socscimed.2004.08.055
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Abstract

The paper explores the attitudes of medical physicians towards adverse incident reporting in health care, with particular focus on the inhibiting factors or barriers to participation. It is recognised that there are major barriers to medical reporting, such as the 'culture of blame'. There are, however, few detailed qualitative accounts of medical culture as it relates to incident reporting. Drawing on a 2-year qualitative case study in the UK, this paper presents data gathered from 28 semi-structured interviews with specialist physicians. The findings suggest that blame certainly inhibits medical reporting, but other cultural issues were also significant. It was commonly accepted by doctors that errors are an 'inevitable' and potentially unmanageable feature of medical work and incident reporting was therefore 'pointless'. It was also found that reporting was discouraged by an anti-bureaucratic sentiment and rejection of excessive administrative duties. Doctors were also apprehensive about the increased potential for managers and non-physicians to engage in the regulation of medical quality through the use of incident data. The paper argues that the promotion of incident reporting must engage with more than the ubiquitous 'culture of blame' and instead address the 'culture of medicine', especially as it relates to the collegial and professional control of quality.

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Crossref · 10.1016/j.socscimed.2004.08.055

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  • Pressure from social norms and shaming can inhibit clinicians from reporting or discussing clinical errors, as it may result in judgments about their competency and damage their reputation.

    “Pressure from social norms and shaming can inhibit clinicians from reporting or discussing clinical errors, as it may result in judgments about their competency and damage their reputation [32,253].”

    From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [253]

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Authors
Waring, J. J.
Affiliations
University of Manchester (GB)
Corresponding author
Waring, Justin J.
ORCID
Waring, Justin J.
Venue
Social Science & Medicine
Publisher
Elsevier BV
Published
2005-05
Volume
60
Issue
9
Pages
1927-1935
ISSN
0277-9536 (ISSN-L)
DOI
10.1016/j.socscimed.2004.08.055
OpenAlex
W1966149969
Cited by
386
References
37
Citations by year
2026: 17 · 2025: 18 · 2024: 8 · 2023: 12 · 2022: 10 · 2021: 21 · 2020: 16 · 2019: 22 · 2018: 21 · 2017: 27 · 2016: 26 · 2015: 32 · 2014: 22 · 2013: 20 · 2012: 19
FWCI
9.14
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Social Science & Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Topics
  • Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
  • Health Sciences › Health Professions › Pharmacy › Medical Malpractice and Liability Issues
  • Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
Keywords
medical culture, physician attitudes, barriers to reporting, medical errors, medical professionalism, collegiality, quality of care, administrative burden, medical quality control
MeSH terms
Attitude of Health Personnel, England, Humans, Malpractice, Medical Staff, Hospital, Medicine, Risk Management, Social Responsibility, Specialization, Truth Disclosure, Organizational Culture, Medical Errors

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