Impact of feeling responsible for adverse events on doctors' personal and professional lives: the importance of being open to criticism from colleagues.

OBJECTIVE: To investigate the impact of adverse events that had caused patient injury and for which the doctor felt responsible, and the experience of acceptance of criticism among colleagues.
DESIGN: Self-reports based on postal questionnaires to 1616 doctors.
SETTING: Norway. PARTICIPANTS: A representative sample of 1318 active doctors.
RESULTS: 368/1294 (28%) reported that they had experienced at least one adverse event with serious patient injury. Being male and working within a surgical discipline (including anaesthesiology, obstetrics and gynaecology) significantly increased the probability of such reports. 38% of the events had been reported to official authorities and, for 17% of doctors, the incident had a negative impact on their private life; 6% had needed professional help. 50% and 54%, respectively, found it difficult to criticise colleagues for their ethically or professionally unacceptable conduct. Doctors who found it easy to criticise colleagues also reported having received more support from their colleagues after a serious patient injury.
CONCLUSION: Male surgeons report the highest prevalence of adverse events. Criticism for professionally and ethically unacceptable conduct is difficult to express among doctors. More acceptance of criticism of professional conduct may not only prevent patient harm, but may also give more support to colleagues who have experienced serious patient injury.