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PSNet: Patient Safety Network
Journal Article

Speaking up—when doctors navigate medical hierarchy.

Srivastava R. The New England journal of medicine. 2013;368:302-5.

This commentary relates a compelling account of how, after a patient's death, two physicians realized that each had harbored qualms about his fitness for surgery but neither spoke up. The author explains how their experience offers lessons on the implications of tacit hierarchy, as well as a path to overcoming it.