In summary, the various sources of emotional variation, described here, may impact on
providers’ cognitive control, and compromise patient safety. How providers feel, and how they
feel towards their patients, may influence their interaction with the patient, their cognition, the
overall calibration of clinical decision making, and ultimately patient safety. In order to achieve
an acceptable level of cognitive control, providers need insight into how these various emotional
processes may lead to error and impact clinical performance. Additionally, the clinician’s
behavior (e.g., suppressing anger towards a patient) may lead to secondary emotional reactions
such as anxiety and physical symptoms. The discovery of error itself may result in significant
anxiety, problematic defense mechanisms, and emotional changes in the physician 71,72,73 that, in
turn, impact patient care. We propose several strategies and recommendations to manage
emotional error and minimize its impact.