Doctors Launch Movement to Break the Cycle of Shame and Blame in Medicine

The Silent Epidemic: Confronting Shame and Infallibility in Medical Culture

The medical profession, built on the expectation of precision and perfection, has long struggled with a pervasive and destructive culture of shame and blame. When errors occur, or when outcomes are poor, the default response is often secrecy and self-recrimination, preventing crucial learning and contributing significantly to physician burnout.

This movement to fundamentally change how doctors process mistakes is being spearheaded by physicians like Dr. Will Bynum, a family medicine physician who experienced the profound impact of shame firsthand during his residency training.

Dr. Bynum recalls the immediate, overwhelming distress that followed a misdiagnosis during his second year of residency. He had treated a patient with what he believed was a simple cold, only for the patient to return later with a serious, life-threatening infection. The error, which could have had devastating consequences, settled over him as intense, isolating shame. Rather than fostering an environment where he could openly discuss the systemic factors contributing to the mistake, the culture demanded silence, reinforcing the idea that the failure was purely personal.

The Personal Cost: Shame as a “Competence Killer”

For decades, medical training has inadvertently cultivated an environment where vulnerability is seen as weakness, and mistakes are viewed as moral failings rather than opportunities for systemic improvement. This psychological burden has far-reaching consequences, affecting not only the well-being of the physician but also the quality of patient care.

Dr. Bynum’s subsequent research into this phenomenon highlights that shame is often rooted in the chasm between the idealized, infallible doctor and the reality of human fallibility. When a doctor fails to meet that impossible ideal, the resulting shame is powerful enough to drive them into isolation.

Psychiatrist Dr. Allan Peterkin, author of The Art of Doctoring, emphasizes the destructive nature of this emotional response:

“Shame is a competence killer. It makes us defensive, it makes us want to hide, and it makes us want to retreat. And that’s the opposite of what we need in medicine.”

Key Consequences of Shame in Medical Practice

When shame dominates the professional landscape, several negative outcomes are exacerbated:

• Secrecy and Isolation: Doctors hide errors, fearing professional repercussions or judgment from peers, preventing timely disclosure to patients and necessary institutional review.
• Defensive Medicine: Physicians order unnecessary tests or procedures to mitigate perceived risk, driven by fear of blame rather than clinical necessity.
• Burnout and Mental Health Crisis: The constant internal pressure and inability to process trauma or mistakes contribute directly to the high rates of depression, anxiety, and suicide among medical professionals.
• Stagnation of Learning: Systemic issues that contributed to the error (e.g., poor handoffs, inadequate staffing, faulty equipment) are never identified or corrected because the focus remains on individual culpability.

Shifting the Paradigm: From Blame to Psychological Safety

Advocates for cultural change are pushing for the adoption of models that prioritize psychological safety—an environment where individuals feel safe to speak up, ask questions, and admit mistakes without fear of punishment or humiliation. This approach draws heavily on the work of vulnerability researcher Dr. Brené Brown and safety models used in high-reliability organizations like aviation.

Instead of asking, “Who is to blame?” the focus shifts to, “What allowed this error to happen?”

Initiatives for Cultural Change

Dr. Bynum and others are actively developing and implementing curricula designed to equip medical professionals with the tools to handle vulnerability and build resilience against shame. These initiatives focus on practical steps:

1. Teaching Vulnerability: Training doctors to recognize and articulate feelings of shame, moving away from the stoic, emotionally detached persona often expected in medicine.
2. Peer Support Networks: Establishing non-judgmental forums where doctors can discuss difficult cases and errors, fostering communal learning rather than isolated suffering.
3. Systemic Analysis: Implementing mandatory post-event reviews that focus on process failures and environmental factors, mirroring the rigorous, non-punitive approach of aviation accident investigation.
4. Open Disclosure: Normalizing the process of disclosing errors to patients, which is crucial for rebuilding trust and ensuring ethical practice.

This shift requires institutional commitment, moving beyond simple wellness programs to fundamentally restructure how mistakes are reported, reviewed, and learned from.

The Patient Safety Imperative

Ultimately, the movement to break the cycle of shame is not just about physician well-being; it is a critical patient safety issue. When doctors are too afraid to admit mistakes, patients are denied the transparency necessary for informed care, and the system loses the opportunity to prevent future harm.

By fostering an environment where doctors can be human—imperfect, vulnerable, and capable of error—the medical community can transition from a culture of punitive secrecy to one of collective accountability and continuous improvement. This transformation is essential for addressing the ongoing crisis of medical errors and ensuring that healthcare systems are truly reliable and trustworthy in 2025 and beyond.

Key Takeaways

• The Problem: Shame and blame are pervasive in medicine, stemming from the impossible expectation of physician perfection.
• The Impact: Shame leads to secrecy, isolation, burnout, and prevents systemic learning from medical errors, ultimately harming patient safety.
• Expert Insight: Dr. Allan Peterkin calls shame a “competence killer” because it drives defensive behavior and hiding.
• The Solution: Advocates like Dr. Will Bynum are promoting psychological safety—a culture where vulnerability is accepted, and mistakes are analyzed systemically, not individually.
• The Goal: Shifting the focus from who failed to what failed, ensuring that errors lead to institutional improvements and better patient outcomes.