Doctors could be forced to say sorry to patients or their relatives if they have been found to have made a mistake.
The proposed move is part of the General Medical Council (GMC) consultation which will help "improve patient protection and public confidence in doctors".
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 said.
And those who fail to blow the whistle on a failing colleague could face stricter sanctions under the plans.
"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.
"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.
"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."
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