Doctors could be forced to apologise to patients or their families if regulators find them to be in the wrong.
A new consultation from the General Medical Council (GMC) questions whether or not doctors across the UK should be required to say sorry if they have previously failed to do so.
Whether or not they have apologised may also be taken into account when a fitness to practice panel is deciding on what sanctions the medic faces, the document states.
Meanwhile, those who fail to blow the whistle if they have concerns about the capability of a colleague could face stricter sanctions under plans outlined in the consultation document.
The doctors' regulator has set out a series of proposals to help "improve patient protection and public confidence in doctors".
The document also seeks views on whether or not doctors who have previously harmed patients, but gone on to show improvements, could still face sanctions.
The GMC said that in some instances it has been prevented from taking action against doctors who have harmed patients because the doctor in question has been able to show that they have subsequently improved their practice.
"In the vast majority of cases one-off clinical errors do not merit any action by the GMC," said GMC chief executive Niall Dickson.
"But if we are to maintain that trust, in the small number of serious cases where doctors fail to listen to concerns and take action sooner to protect patients, they should be held to account for their actions.
"There have been occasions when we have been prevented from taking action in serious cases because the doctor has been able to show that they have subsequently improved their practice. We believe that doctors and patients want stronger action in these serious cases.
"It is also right that patients or their families are told what went wrong and if appropriate they should be given a full apology. We believe this should be taken into account when deciding what if any sanction needs to be imposed to protect future patients and uphold the reputation of the profession.
" We want patients, doctors and other professionals to give us their views - this consultation is a chance to make sure the action we take is fair to doctors while never losing our focus on protecting the public."
The consultation was launched today and will close on November 14.
Dr Helen Stokes-Lampard, honorary treasurer of the Royal College of General Practitioners, said: "Patient safety is always of paramount importance and GPs work really hard to ensure that all patients receive the best possible care.
"GPs are the most trusted healthcare professionals in the NHS and share a unique relationship with their patients. According to the latest independent GP patient survey, over 90% of patients are highly satisfied with the care and services provided by their GP but in a small number of cases where things do go wrong - or nearly go wrong - it is important that these are addressed and that we learn from them.
"All GP practices have a system to review instances where things could have gone better and GPs are required to reflect on 'significant events' during their annual appraisal and through the revalidation process.
"Anything that further improves the care that we deliver to our patients - and the trust that they have in us should be welcomed. But it is essential that any action resulting from these proposals is taken in the best interests of patient safety and care and not used as an excuse to criticise doctors who are doing a very difficult job in increasingly difficult circumstances."