Bearing the Burden or Baring the Soul: Physicians' Self-Disclosure and Boundary Management Regarding Medical Mistakes

Abstract

Within a boundary management framework, this study explored how physicians manage self-disclosure regarding medical mistakes amidst boundary constraints imposed by risk management, legal mandate, and the medical culture. Descriptive statistics from questionnaires and exemplars from accompanying narratives showed that the 39 internists and family physicians in this study chose to control their own boundaries by revealing errors most often to other physicians to facilitate learning. Although risk management and the medical culture do not appear to deter physicians from disclosing errors at a superficial level, physicians maintain tight personal boundaries at the emotional level. Perhaps if physicians could disclose errors at the emotional level, their mental energies could be more positively channeled to patients' needs, resulting in improved patient care.