1. Joshua M. Liao ( ) is a resident physician at Brigham and Women’s Hospital, a clinical fellow in medicine at Harvard Medical School, and the cofounder and chair of the Brigham and Women’s Hospital Housestaff Safety and Quality Council, in Boston, Massachusetts.
2. Eric J. Thomas is a professor of medicine, an associate dean for health care quality, and the director of the University of Texas at Houston—Memorial Hermann Center for Healthcare Quality and Safety at the University of Texas Medical School at Houston.
3. Sigall K. Bell is an assistant professor of medicine at Beth Israel Deaconess Medical Center and Harvard Medical School and the director of patient safety and quality initiatives at the Institute for Professionalism and Ethical Practice at Boston Children’s Hospital. The names of the patient and physician in the story have been changed to maintain confidentiality. The authors thank Tom Delbanco, David Browning, and Edward Hundert for their thoughtful review of the manuscript. Sigall Bell...