Doctors seem less likely to report medical errors to hospitals than what they themselves think should be reported, research suggests.

University of Iowa researchers published the findings in the Archives of Internal Medicine (Jan. 14, 2008). A related UI-led study, published in the Journal of General Internal Medicine (May 2007) found a similar, although smaller, gap between physicians' attitudes and actual actions in the disclosing of medical errors to patients.

Information from the two studies, which were based on surveys of doctors in U.S. teaching hospitals, shows an apparent disconnect between error disclosure to patients and error reporting to hospitals, said Lauris Kaldjian, MD, PhD, associate professor of internal medicine at the UI Roy J. and Lucille A. Carver College of Medicine.

"I think it points to the need for a more integrated view of medical error communication," Kaldjian said.

As an example, 41 percent of physicians in the earlier study said they actually had disclosed a minor error to a patient but only 18 percent of physicians in the current study said they had reported a minor error to their hospital.

"Taken together, the findings indicate that physicians have more experience talking to patients about medical errors than reporting them to hospitals," said Kaldjian, who also is director of the college's Program in Biomedical Ethics and Medical Humanities.

"It may be that physicians find it more important or meaningful to talk to patients about mistakes and may not see as much value in communicating the same mistakes to a reporting system," he added.

The discrepancy between attitude and action is particularly notable, Kaldjian said, given that the survey showed that 84 percent of physicians believe error reporting can improve the quality of care.

Other findings from the survey may help explain the gap: Only 55 percent of the respondents knew how to report errors, and only 39 percent knew what kinds of errors to report.

"The fact that nearly every physician is likely to make a minor error at some point, taken together with the lack of understanding on how and what to report, indicates we need to clarify what errors should be reported and how to report them," he said.

—Becky Soglin