Bearing the burden or baring the soul: physicians' self-disclosure and boundary management regarding medical mistakes

Area of Science:

• Medical ethics
• Physician communication
• Patient safety

Background:

• Physicians face complex boundary constraints when disclosing medical errors, influenced by risk management, legal requirements, and medical culture.
• Understanding how physicians manage self-disclosure of errors is crucial for improving patient care and physician well-being.

Purpose of the Study:

• To explore physicians' self-disclosure of medical mistakes within a boundary management framework.
• To identify factors influencing physicians' decisions to disclose or withhold information about errors.

Main Methods:

• Utilized descriptive statistics from questionnaires administered to physicians.
• Analyzed qualitative data from accompanying narratives to understand physicians' experiences.
• Focused on 39 internists and family physicians.

Main Results:

• Physicians predominantly disclosed errors to other physicians to facilitate learning.
• Superficial disclosure of errors was not significantly deterred by risk management or medical culture.
• Physicians maintained significant emotional boundaries regarding error disclosure.

Conclusions:

• Physicians strategically manage self-disclosure of medical errors, prioritizing peer learning over emotional sharing.
• The emotional boundary surrounding error disclosure may impede physicians' ability to positively channel mental energy towards patient needs.
• Facilitating emotional disclosure could potentially enhance patient care and physician support systems.