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What is good performance and how can we regulate to ensure it?

When a high profile scandal hits, whether it is Enron, the sub-prime mortgage crisis, or dramatic medical failures, it is claimed that the regulatory regime has failed and a better framework is needed. Everyone agrees that we want good regulation, but what makes for good regulation is often the subject of much debate. And though everyone wants “good” doctors, precisely what “goodness” might involve, how it might be assessed, and what role regulation might play are questions that remain challenging, How can we institute an effective and legitimate regulatory framework in a complex profession like medicine, where what regulation is intended to achieve – for example, ‘safe practice’ – is often contested?  Work on this fellowship seeks to explore where the balance should be struck between two distinct approaches to regulating doctors. One increasingly popular approach involves setting formal standards against which medical performance can be judged. A second, contrasting approach involves relying on professionals to exercise competent professional judgment, acquired through years of practice, to respond to individual situations in complex circumstances. Should we prefer one of these two much-debated approaches over the other, should we discard both of them in favour of something else, or can we somehow have the best of both worlds?

What the research means to policy-makers and the wider community

 Research Methods

The project will bring together data from a variety of sources by using:

Research details

The project, ‘Regulating Doctors: Between performance and practice’, runs from January  2008 to March 2009.

Other Project Outputs and Related Webpages

Tarrant, C, Dixon-Woods, M, Colman, A M, and Stokes, T (2010) Continuity and Trust in Primary Care: A Qualitative Study Informed by Game Theory, Annals of Family Medicine 8:440-446

Yeung K, Dixon-Woods M (2010) Design-based regulation and patient safety: a regulatory studies perspective. Social Science and Medicine 71: 502-509

Dixon-Woods M. (2010) Why is patient safety so hard? : a selective review of ethnographic studies, Journal of Health Services Research & Policy, 15:11-16

Dixon-Woods and Tarrant C (2009) Why do people cooperate with medical research? Findings from three studies, Social Science and Medicine, Vol 374 (9688): 2215-2222

C. Bosk, M. Dixon-Woods, C. Goeschel, P. Pronovost Reality check for checklists, The Lancet, Vol 374, Issue 9688,: 444-445

Dixon-Woods M., and Ashcroft, R. (2008)  ‘Regulation and the Social Licence for Medical Research’, Medicine, Health Care and Philosophy,

Research Team

Mary Dixon-Woods

Mary Dixon-Woods is Professor of Medical Sociology in the Department of Health Sciences, University of Leicester. Her research focuses on: development of methods for synthesizing diverse forms of evidence; quality and safety in healthcare, using a distinctively sociological approach; and the sociology of regulation and bioethics. She is associate editor of Quality and Safety in Healthcare.