This commentary presents the issues surrounding appropriate disclosure of medical errors. Discussion includes the challenges and barriers to full disclosure, strategies for the medical establishment to enhance it, and the debated impact of the malpractice environment on hindering such communication. The authors advocate for a proactive approach to managing these tensions both as a professional responsibility and a strategy for improvement. They suggest developing guidelines for disclosure and incorporating these practices into existing quality improvement initiatives. The discussion provides an overview and perspective on a topic that continues to generate news in many aspects of the health care sector.