Provider–Patient Communication Failures: What the Data Tells Us

Clear, effective communication between clinicians and patients or families is foundational to safe care. Candello data continue to show, however, that communication failures remain a persistent and growing source of patient safety risk. New benchmarking data suggest that communication between providers and patients or families is under increasing strain, and the consequences are both clinical and financial.

The 2025 Candello Benchmarking Report, Malpractice Risks in Communication Failures: A 10-year Follow Up, looked closely at medical professional liability (MPL) cases closed between 2014 and 2024 and compared the findings to a previous benchmarking report published in 2015. The analysis showed a continued rise in cases involving any communication failure (40 percent, up from 30 percent). Most notable was the increase of proportion of cases with provider–patient communication failures (58 percent to 63 percent). These are not low-impact events: 40 percent of such cases closed with an indemnity payment, averaging $338,000.

Where Communication Breaks Down

Candello’s data offer insight into how provider–patient communication failures manifest in real-world care and where safety interventions may have the greatest impact.

Communication failures are not confined to a single specialty but rather reflect systemic vulnerabilities across care delivery. These data show that communication failures most often arise not from unexpected events, but from how known risks, clinical decisions, and evolving information are explained—or not explained—to patients and families. When expectations are misaligned and rapport is weak, even foreseeable complications and defensible care can escalate into patient harm and malpractice claims.

Claims patterns point to high-risk clinical contexts

The allegations associated with these cases further illustrate where communication vulnerabilities concentrate. Surgical treatment (non-anesthesia related) accounted for 33 percent of claims, followed closely by medical treatment (non-OB related) at 31 percent. Diagnosis-related issues made up 14 percent of allegations, reflecting the persistent risk posed by missed or delayed diagnoses when communication falters. Smaller but meaningful proportions involved failures to provide safety (5 percent) and improper medication management (4 percent).

Claims involving provider–patient communication failures most frequently arose in ambulatory settings (60 percent), underscoring that communication risk is not confined to high-acuity environments but is embedded in everyday care. These cases often involve follow-up, expectation-setting, and shared understanding over time, representing areas where small gaps can accumulate. Still, more than one-third of cases occurred in inpatient settings (34 percent), where complexity, multiple care teams, and frequent transitions increase the likelihood of miscommunication. Emergency care accounted for 6 percent of cases, reflecting the inherent challenge of establishing clear, patient-centered communication amid time pressure, diagnostic uncertainty, and urgent decision-making.

Dr. Adam Schaffer, CRICO’s Senior Clinical Analytics Specialist and contributor to the report comments, “In a fascinating way [the increase in the proportion of cases that involved communication between the provider and patient] really reflects some of the macro trends we’re seeing in healthcare. I think one of those key trends is that we can attribute some of what we saw to the increase in the complexity and acuity of what’s expected to take place in the outpatient setting.”

The Cost of Communication Failures

The financial impact of communication failures extends beyond individual claims and reflects system-level inefficiencies. In addition to Candello analyses, a 2018 study estimated that reducing communication barriers in health care could prevent more than 670,000 adverse events annually and save approximately $6.8 billion each year.

What This Means for Patient Safety Leaders and Clinicians

Improving provider–patient communication is one of the most actionable patient safety strategies available. While telecommunication tools can support information exchange, they cannot replace clear expectation-setting, confirmation of understanding, and empathetic responses to patient concerns. As health care grows more complex, safety depends not only on clinical expertise, but on ensuring that patients and families are informed partners in care.

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