Objectives:
To describe how physicians think and feel about their perceived mistakes, to examine how physicians’ prior beliefs and manners
of coping with mistakes may influence their emotional responses, and to promote further discussion in the medical community
about this sensitive issue.
Design:Audiotaped, in-depth interviews with physicians in which each physician discussed a previous mistake and its impact on his
or her lift. Transcripts of the interviews were analyzed qualitatively and the data organized into five topic areas: the nature
of the mistake, the physician’s beliefs about the mistake, the emotions experienced in the aftermath of the mistake, the physician’s
way of coping with the mistake, and changes in the physician’s practice as a result of the mistake.
Participants and setting:Eleven general internists and medical subspecialists practicing at a community, university-affiliated hospital in Oregon.
Results:Themes emerging from analysis of the interviews were the ubiquity of mistakes in clinical practice; the infrequency of self-disclosure
about mistakes to colleagues, family, and friends; the lack of support among colleagues; the degree of emotional impact on
the physician, so that some mistakes were remembered in great detail even after several years; and the influence of the physician’s
professional locus of control on subsequent emotions.
Conclusions:The perception of having made a mistake creates significant emotional distress for practicing physicians. The severity of
this distress may be influenced by factors such as prior beliefs and perfectionism. The extent to which physicians share this
distress with colleagues may be influenced by the degree of competitiveness engendered by medical training. Open discussion
of mistakes should be more prominent in medical training and practice, and there should be continued research on this topic.
Key words mistakes - physician impairment - stress - disclosure - coping