Hospital incident reporting systems are ubiquitous but limited, as their voluntary nature results in many events going unreported. Prior research has documented that physicians, in particular, do not file incident reports. This evaluation of more than 260,000 incident reports from a broad cross-section of hospitals examined links between the severity of the incident and who reported the incident. Physicians reported only 1.1% of all events, similar to a prior study using the same incident reporting system, but physicians did tend to report incidents that caused more harm to patients. A successful intervention to improve physician incident reporting was described in a prior study.