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

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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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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 › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
Social Sciences › Law › Medical Malpractice and Liability Issues
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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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Beyond blame: cultural barriers to medical incident reporting

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