Medical regulation, spectacular transparency and the blame business
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 2 November 2010
Abstract
Purpose
The purpose of this paper is to explore general practitioners' (GPs') and psychiatrists' views and experiences of transparent forms of medical regulation in practice, as well as those of medical regulators and those representing patients and professionals.
Design/methodology/approach
The research included interviews with GPs, psychiatrists and others involved in medical regulation, representing patients and professionals. A qualitative narrative analysis of the interviews was then conducted.
Findings
Narratives suggest rising levels of complaints, legalisation and blame within the National Health Service (NHS). Three key themes emerge. First, doctors feel “guilty until proven innocent” within increasingly legalised regulatory systems and are consequently practising more defensively. Second, regulation is described as providing “spectacular transparency”, driven by political responses to high profile scandals rather than its effects in practice, which can be seen as a social defence. Finally, it is suggested that a “blame business” is driving this form of transparency, in which self‐interested regulators, the media, lawyers, and even some patient organisations are fuelling transparency in a wider culture of blame.
Research limitations/implications
A relatively small number of people were interviewed, so further research testing the findings would be useful.
Practical implications
Transparency has some perverse effects on doctors' practice.
Social implications
Rising levels of blame has perverse consequences for patient care, as doctors are practicing more defensively as a result, as well as significant financial implications for NHS funding.
Originality/value
Transparent forms of regulation are assumed to be beneficial and yet little research has examined its effects in practice. In this paper we highlight a number of perverse effects of transparency in practice.
Keywords
Citation
McGivern, G. and Fischer, M. (2010), "Medical regulation, spectacular transparency and the blame business", Journal of Health Organization and Management, Vol. 24 No. 6, pp. 597-610. https://doi.org/10.1108/14777261011088683
Publisher
:Emerald Group Publishing Limited
Copyright © 2010, Emerald Group Publishing Limited