There’s a certain logic to doctors who don’t disclose their mistakes: their reputation, discipline, and the looming threat of medical malpractice lawsuits incentivize silence. However, patients display an unexpected silence about their own suffering—even when they know mistakes have been made.

Both problems undermine a patient-focused environment and stifle error reporting that could reduce medical mistakes.

The thought of medical errors isn’t likely to be on patients’ minds as they’re wheeled into an operating room, according to research by the Institute for Healthcare Improvement and National Patient Safety Foundation.

In fact, these watchdog groups discovered in their poll of 2,536 adults that nearly two-thirds of Americans don’t believe medical errors are likely to happen to them. The harsh reality is that 21 percent have experienced at least one.

Patient advocacy groups are convinced that speaking up about errors can actually make a difference in lowering systemic risks for everyone who needs surgery. However, many patients don’t report mistakes even when they become aware that an error is responsible for their present suffering.