BMJ Qual Saf doi:10.1136/bmjqs.2010.048173
  • Original research

Professional values and reported behaviours of doctors in the USA and UK: quantitative survey

Open AccessPress Release
  1. Eric G Campbell5
  1. 1Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Cambridge, UK
  2. 2Massachusetts General Hospital, Biostatistics Center and Mongan Institute for Health Policy, Boston, Massachusetts, USA
  3. 3National Primary Care Research and Development Centre, University of Manchester, Manchester, UK
  4. 4Centre for Primary Care and Population Research, University of Dundee, The Mackenzie Building, Dundee, UK
  5. 5Harvard Medical School, Massachusetts General Hospital, Mongan Institute for Health Policy, Boston, Massachusetts, USA
  1. Correspondence to Professor Martin Roland, Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Robinson Way, Cambridge CB2 0SR, UK; mr108{at}
  • Accepted 20 December 2010
  • Published Online First 7 March 2011


Background The authors aimed to determine US and UK doctors' professional values and reported behaviours, and the extent to which these vary with the context of care.

Method 1891 US and 1078 UK doctors completed the survey (64.4% and 40.3% response rate respectively). Multivariate logistic regression was used to compare responses to identical questions in the two surveys.

Results UK doctors were more likely to have developed practice guidelines (82.8% UK vs 49.6% US, p<0.001) and to have taken part in a formal medical error-reduction programme (70.9% UK vs 55.7% US, p<0.001). US doctors were more likely to agree about the need for periodic recertification (completely agree 23.4% UK vs 53.9% US, p<0.001). Nearly a fifth of doctors had direct experience of an impaired or incompetent colleague in the previous 3 years. Where the doctor had not reported the colleague to relevant authorities, reasons included thinking that someone else was taking care of the problem, believing that nothing would happen as a result, or fear of retribution. UK doctors were more likely than US doctors to agree that significant medical errors should always be disclosed to patients. More US doctors reported that they had not disclosed an error to a patient because they were afraid of being sued.

Discussion The context of care may influence both how professional values are expressed and the extent to which behaviours are in line with stated values. Doctors have an important responsibility to develop their healthcare systems in ways which will support good professional behaviour.


  • Funding Nuffield Trust, Institute on Medicine as a Profession.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

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