The role of talking (and keeping silent) in physician coping with medical error: a qualitative study.
OBJECTIVE
The aim was to examine the role of talking (or remaining silent) in the physician's experience of coping with medical error.


METHODS
Sixty-one physicians participated in in-depth interviews about their experience of coping with a serious medical error. We analyzed verbatim transcripts to develop a taxonomic analysis of talking domains to capture the physician experience of talking and coping with error.


RESULTS
Talking (or not talking) about a medical error was an important aspect of the physicians' experience. After an error, honest conversations with patients and families, the medical team, colleagues, mentors, and others were critical early steps toward healing. Talking with others was important for processing and finding meaning. Many physicians used their stories to teach and help others. Some types of conversation were unhelpful, such as those that were cruel, insensitive, self-serving, and dishonest. Talking with well-intentioned colleagues and family members was often unhelpful if they minimized the error.


CONCLUSIONS
Physicians' opportunities to talk about their experience in a meaningful way is associated with their ability to recover after a serious medical error.


CONCLUSIONS
This work may inform institutional policies, practices, and training to help physicians effectively prepare for and cope with medical error.
Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA. nbmay@verizon.net
Natalie
N
May
Margaret
M
Plews-Ogan
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003142:Communication; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D019300:Medical Errors / Q000523:psychology*; D008875:Middle Aged; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D036301:Qualitative Research; D013637:Tape Recording