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I have read this article as well and it has received much deserved attention. This is an interesting issue for all of us in medicine and one which we historically have not openly discussed for obvious reasons. Even today these type of discussions can be distorted and taken out of context for the sake of sensational impact which does not advance the meaningful nature of discourse. This dialogue is very important for us all to continue to change the "culture" of transparency in medicine.

As a pediatric intensivist I have been involved in many scenarios over the years that have precipitated deep reflection of what my role was in a patient's outcome. I must say I can not recall a specific fatal mistake (maybe it's surpressed) that I personally made but certainly a collective failure of a team,process or system, etc. which is no better. Whenever there is an outcome that does not "feel right" or meet acceptable benchmark standards I have always personalized this so it does not feel any different to me, or for that matter, the patient. I think many physicians are the same along these lines. When the day comes that I am not effected or moved by outcomes of my patients then it's off to the restaurant business.

No healthcare provider wants to harm a patient!! What is important for me personally and us here at CCCH is to continue to develop a cultural environment immersed in transparency, mutual support and professional honesty. We have worked hard at CCCH to live a culture of safety and continuous quality improvement for our patients as Dr, Ackerman has stated.

This begins with the ability to openly admit mistakes amongst ourselves and the patient's families while building an infrastructure and system goals that support outstanding patient quality. Nothing else is acceptable.

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