Too busy and too complicated. These are the typical excuses one might expect when medical professionals are asked why they fail to use online error-reporting systems designed to improve patient safety and the quality of care. But Johns Hopkins investigators found instead that the most common reasons among radiation oncologists were fear of getting into trouble and embarrassment. Investigators emailed an anonymous survey to physicians, nurses, radiation physicists and other radiation specialists at Johns Hopkins, North Shore?Long Island Jewish Health System in New York, Washington University in St. Louis and the University of Miami, with questions about their reporting near misses and errors in delivering radiotherapy. Each of the four centers tracks near misses and errors through online intradepartmental systems.