In a recent TEDMed Talk, Dr. Danielle Ofri of the Bellevue Hospital Center at New York University put forth a radical proposition for physicians and hospitals: talk more about your mistakes. Dr. Ofri believes that when physicians feel comfortable enough that they are able to be transparent with their mistakes, patient safety standards can be improved.
A Culture of Perfectionism
From the dawn of the profession, physicians have been touted as society’s intellectual and academic leaders. As the keepers of health and safety, doctors have had a culture of perfectionism thrust upon them by society. However, Ofri believes that the thought that doctors should be error-free in their work has created a “toxic” professional environment. 
The truth is that no doctor is perfect—and, despite expectations to the contrary, none has a clean record. FierceHealthcare reports that nearly 325,000 people die in the United States every year because of preventable or omission-based mistakes made by their physicians. In response, the Institute of Medicine, working with several prominent politicians, has proposed enacting regulations that require healthcare organizations and their staffs to report any serious injuries or deaths caused by human error.
While this idea is supported by those like Ofri who believe that mistakes, though tragic, are sometimes inevitable, many other physicians are reluctant to join a culture in which they openly report or share their mistakes. According to Ethical Forum, many doctors fear retribution in the form of job loss or a pricey and potentially career-ruining malpractice lawsuit. Physicians must also face their own sense of failure and shame. They hold themselves to high standards and often find it difficult to admit errors to patients or colleagues.
Encouraging Openness
Despite these barriers to a new culture of disclosure,Ofri believes that the best way to improve the profession and, in turn, improve overall patient safety is to reduce physician omissions. “Despite our best efforts,” she explains, “there is no way to improve without acknowledgement of our imperfections.”
First, doctors must learn that their mistakes do not automatically mean that aggrieved families will retaliate with lawsuits. As Ethical Forum points out, the majority of lawsuits do not occur simply because mistakes were made. They occur when the victims (or their loved ones) believe that the physician has withheld information or has not been totally honest about the cause of death or injuries. A change in bedside manner from distant and calculating to sympathetic and open can go a long way in preventing malpractice suits.
Safe Environment for Disclosure
Though a mistake made by a doctor is likely to have the most devastating impact on a patient and be the most high profile, physicians aren’t the only individuals who can and do make mistakes in a hospital. Errors made by anyone from a nurse to an aide, can negatively impact a patient’s care. Rather than hiding mistakes that might lead to even more problems down the road, each individual in the hospital needs to feel safe enough to fully disclose any error that could compromise a patient’s health or safety.
Creating such an environment needs to be a priority for the leaders of healthcare organizations. According to the white paper, 10 Things Healthcare Leaders Must Do to Create a Culture of Safety, “When a problem does occur, leaders must focus on improving the system rather than on placing blame.”
Further, a record of common errors documented and shared among staff can lead to transparency in the practice. This, ultimately, can serve as a guide for both physicians and administrators to change policies or procedures that may interfere with safety protocols. Without enough data to warrant a change or shift in policy, avoidable mistakes may continue to occur.
The Case for Transparency
According to Dr. Orfi, those in the medical industry “need to undo a toxic culture of perfection when it comes to medical error.” This can be accomplished in an environment in which physicians and other staff members do not automatically fear lawsuits or career repercussions. From there, administrators can capitalize on the new transparency in order to truly improve patient safety.


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