Regrets In Medicine: Doctors Should Engage with Their Emotions

Regret in Medicine: The Hidden Burden Doctors Bear

Regret is an unavoidable part of life. It’s that gnawing feeling that a different choice might have led to a better outcome. For healthcare providers who dedicate themselves to their patients’ well-being, regret is not just common — it’s universal. It follows in the wake of an adverse outcome, a recurrence of illness, or a treatment complication. I’ve felt it when I hesitated to push for more aggressive care and later wished I had. I’ve felt it just as strongly when I advocated for a treatment that, in hindsight, was too aggressive and led to an unpredictable adverse event.

Dr. Carter Labares, a professor of surgery at UCSF, teaches about the emotional toll of regret in medicine. She describes one example of regret. She was caring for a person with severe arterial disease. Dr. Labares performed surgery many times on several parts of the woman’s body. Each time was more complicated than the last. She wasn’t trying to cure her, just buy her more time.

“When the final operation occurred, where I opened her body and saw that there was nothing more I could do. I went to see her family, and it was horrible to tell them that she was going to die from this episode,” she says. “So I didn’t do anything wrong, but I still felt like I wish there had been more I could have done. So I guess what I mean by regret is just the wish that things had turned out better.”

For clinicians, regret often carries the weight of failure, self-doubt, and even guilt. But it’s important to distinguish this kind of regret from preventable medical errors, like performing surgery on the wrong leg. This is the regret that arises despite sound clinical judgment — when bad outcomes occur despite the best efforts and decisions.

On the one hand, we want doctors to be optimistic — to believe in the possibility of a cure, to push forward when the odds seem long.

The challenge is that most doctors are never taught how to manage the emotional fallout when things go wrong. Dr. Labares recalls a difficult moment early in her training when surgery for one of her patients didn’t go as planned. She had to break the news.

“I just spontaneously burst into tears, and I was so embarrassed, because we’re really trained in surgery to hold all of that emotion separate to make room for what the patient and the family feels,” she says.

Even when patients accept poor outcomes, doctors can suffer what’s known as “second victim syndrome” — lasting emotional distress after an adverse event. It can lead to rumination, difficulty concentrating, and self-doubt in future decision-making.

Dr. Labares emphasizes that dealing with these emotions is essential — not necessarily in the heat of the moment, but in time.

“We can maybe save it for later and go back and make sure that people are okay.”

Despite many surgeons’ reluctance to engage with their emotions, research shows that acknowledging regret and sharing grief with patients doesn’t weaken the doctor-patient relationship — it strengthens it. It fosters forgiveness, builds trust, and, ultimately, makes medicine more human.

– Dr. Michael Wilkes with a Second Opinion