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Transparency When Things Go Wrong: Physician Attitudes About Reporting Medical Errors to Patients, Peers, and Institutions
Open accessAbstract
Objectives: Transparent communication after medical error includes disclosing the mistake to the patient, discussing the event with colleagues, and reporting to the institution. Little is known about whether attitudes about these transparency practices are related. Understanding these relationships could inform educational and organizational strategies to promote transparency. Methods: We analyzed responses of 3038 US and Canadian physicians to a medical error communication survey. We used bivariate correlations, principal components analysis, and linear regression to determine whether and how physician attitudes about transparent communication with patients, peers, and the institution after error were related. Results: Physician attitudes about disclosing errors to patients, peers, and institutions were correlated (all P's < 0.001) and represented 2 principal components analysis factors, namely, communication with patients and communication with peers/institution. Predictors of attitudes supporting transparent communication with patients and peers/institution included female sex, US (vs Canadian) doctors, academic (vs private) practice, the belief that disclosure decreased likelihood of litigation, and the belief that system changes occur after error reporting. In addition, younger physicians, surgeons, and those with previous experience disclosing a serious error were more likely to agree with disclosure to patients. In comparison, doctors who believed that disclosure would decrease patient trust were less likely to agree with error disclosure to patients. Previous disclosure education was associated with attitudes supporting greater transparency with peers/institution. Conclusions: Physician attitudes about discussing errors with patients, colleagues, and institutions are related. Several predictors of transparency affect all 3 practices and are potentially modifiable by educational and institutional strategies.
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“Moreover, due to the fear of undermining professional relationships, specialists frequently do not report diagnostic errors.”
From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [254]
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“For example, when a specialist discovers an error, they often avoid reporting it to the original specialist or making referrals about it [254,255].”
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Metadata
- Authors
- Bell, S. K., White, A. A., Yi, J. C., Yi-Frazier, J. P., & Gallagher, T. H.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- From the *Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA; †Department of Medicine, University of Washington, Seattle, WA; ‡Clinical Research Division, Biobehavioral Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; §Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA; and ∥Seattle Children's Research Institute, Seattle, WA.
- Corresponding author
- Bell, Sigall K.
- Venue
- Journal of Patient Safety
- Published
- 2017-12
- Volume
- 13
- Issue
- 4
- Pages
- 243-248
- ISSN
- 1549-8417 (ISSN-L)
- 1549-8425
- OpenAlex
- W1995708169
- Cited by
- 52
- References
- 27
- Citations by year
- 2026: 5 · 2025: 1 · 2024: 3 · 2023: 5 · 2022: 4 · 2021: 6 · 2020: 5 · 2019: 3 · 2018: 11 · 2017: 2
- FWCI
- 11.50
- Type
- journal article
- Language
- en
- Open access
- Locations
- Journal of Patient Safety (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Arnold P. Gold Foundation
- Agency for Healthcare Research and Quality (R01HS016506)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
- Social Sciences › Law › Medical Malpractice and Liability Issues
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Keywords
- medical error disclosure, transparency, physician attitudes, patient disclosure, peer-to-peer communication, institutional reporting, medical error reporting, patient trust, litigation risk, academic vs private practice, sex differences
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Communication, Female, Humans, Male, Middle Aged, Physician-Patient Relations, Physicians, Surveys and Questionnaires, Truth Disclosure, Medical Errors, Young Adult
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