Understanding the Barriers to Physician Error Reporting and Disclosure: A Systemic Approach to a Systemic Problem

    Authors

    B. Perez; S. A. Knych; S. J. Weaver; A. Liberman; E. M. Abel; D. Oetjen;T. T. H. Wan

    Comments

    Authors: contact us about adding a copy of your work at STARS@ucf.edu

    Abbreviated Journal Title

    J. Patient Saf.

    Keywords

    physician-patient communication; error disclosure; medical malpractice; medical errors; error reporting; transparency; MEDICAL ERRORS; PATIENT SAFETY; MALPRACTICE CLAIMS; MISTAKES; STUDENTS; ATTITUDES; EMPATHY; SCHOOL; COMMUNICATION; INFORMATION; Health Care Sciences & Services; Health Policy & Services

    Abstract

    Introduction The issues of medical errors and medical malpractice have stimulated significant interest in establishing transparency in health care, in other words, ensuring that medical professionals formally report medical errors and disclose related outcomes to patients and families. However, research has amply shown that transparency is not a universal practice among physicians. Methods A review of the literature was carried out using the search terms "transparency," "patient safety," "disclosure," "medical error," "error reporting," "medical malpractice," "doctor-patient relationship," and "physician" to find articles describing physician barriers to transparency. Results The current literature underscores that a complex Web of factors influence physician reluctance to engage in transparency. Specifically, 4 domains of barriers emerged from this analysis: intrapersonal, interpersonal, institutional, and societal. Conclusion Transparency initiatives will require vigorous, interdisciplinary efforts to address the systemic and pervasive nature of the problem. Several ethical and social-psychological barriers suggest that medical schools and hospitals should collaborate to establish continuity in education and ensure that knowledge acquired in early education is transferred into long-term learning. At the institutional level, practical and cultural barriers suggest the creation of supportive learning environments and private discussion forums where physicians can seek moral support in the aftermath of an error. To overcome resistance to culture transformation, incremental change should be considered, for example, replacing arcane transparency policies and complex reporting mechanisms with clear, user-friendly guidelines.

    Journal Title

    Journal of Patient Safety

    Volume

    10

    Issue/Number

    1

    Publication Date

    1-1-2014

    Document Type

    Review

    Language

    English

    First Page

    45

    Last Page

    51

    WOS Identifier

    WOS:000335830300006

    ISSN

    1549-8417

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