BEARING THE BURDEN OR BARING THE SOUL - PHYSICIANS SELF-DISCLOSURE AND BOUNDARY MANAGEMENT REGARDING MEDICAL MISTAKES

Within a boundary management framework, this study explored how physic ians manage self-disclosure regarding medical mistakes amidst boundary constraints imposed by risk management, legal mandate, and the medica l culture. Descriptive statistics from questionnaires and exemplars fr om accompanying narratives showed that the 39 internists and family ph ysicians in this study chose to control their own boundaries by reveal ing errors most often to other physicians to facilitate learning. Alth ough risk management and the medical culture do not appear to deter ph ysicians from disclosing errors at a superficial level, physicians mai ntain tight personal boundaries at the emotional level. Perhaps if phy sicians could disclose errors at the emotional level, their mental ene rgies could be more positively channeled to patients' needs, resulting in improved patient care.