Patient involvement in safety is being promoted, through the use of seemingly simple techniques such as encouraging patients to ask their physicians if they washed their hands. This study surveyed surgical patients regarding their willingness to ask their physicians and nurses factual questions (eg, "When can I return to my normal activities?") and challenging questions (eg, "Did you wash your hands?"). Patients were far less willing to ask challenging, safety-related questions than factual questions, particularly of physicians. A prior study conducted in medical patients found similar results. Engaging patients in safety activities will involve a considerable amount of culture change, particularly regarding providers' willingness to field challenging questions.