Health care, in particular, subscribes to the myth that perfect performance is achievable. Punishment is used as a negative incentive in an attempt to attain perfect performance and thus eliminate events. This type of work environment is calld a "punitive" culture.

While no one would disagree with the goal of perfect performance, it should be kept in mind that it is only a goal perfection is not a human attribute.

Punishment as a motivational tool has been the traditional approach in medicine; however, this emphasis on perfection has several potential adverse consequences.