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The fear of litigation and shame associated with making a mistake can be paralyzing for health care professionals. However, remaining silent and isolated from the patient can increase physician distress when it conflicts with the physician’s perceptions of the ethical and moral duties associated with disclosure. This can exacerbate second victim syndrome—shame, anger, depression, inadequacy, loss of confidence—which is well documented among physicians who are involved in unanticipated outcomes and is a contributing factor in physician burnout. While patients should be the focus of disclosure, it is also important to consider the benefits of disclosure for physicians. Research indicates that disclosure may help physicians process the emotions associated with an unanticipated outcome and can increase physician/provider well-being.

Organizational awareness of second victim syndrome and an institutional response plan for it are critical to minimizing its stress on a clinician. Clinician support must become a predictable and required part of the health care operational response to stressful clinical events. Leadership engagement and a strong infrastructure for clinician support are essential to effectively address second victim syndrome, which can lead to physician burnout.

Physicians should be encouraged to discuss with family, friends, and colleagues the range of feelings that could occur—for example, sadness, fear, guilt, or anger—in response to an adverse event. (Any discussions of feelings should be distinguished from discussion of the facts surrounding patient care and the adverse event, which are confidential.) Unfortunately, there is minimal protected time for clinicians to comprehend and process an unanticipated or adverse event before moving on to their other responsibilities. The strategic placement of trained peers allows for real-time emotional support for clinicians and maximizes the limited time physicians have available.

Health care organizations bear a heavy burden in reducing physician burnout among their physicians, because the organization has the power to reduce many of the workplace stressors causing burnout. Without intervention, burnout harms physicians, creates a negative workplace culture, threatens patient safety, and increases medical liability risk exposure. Patient safety culture, also known as just culture, ensures balanced workplace accountability for individuals and the organization responsible for designing and improving systems.

Patient experience—“the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care”¹—is playing an increasingly significant role in the business success of medical practices. The impact is felt throughout the practice: online physician ratings, reimbursement levels, patient acquisition, and patient retention. In light of this, practices should consider ways to enhance the overall experience that patients have with their practices.