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Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care
Ebook Download Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care
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Review
“A startling revelation of the dysfunction deeply embedded in the very culture of American medical practice, problems that health care reform scarcely begins to address.†―Peter Boyer, senior correspondent for Newsweek“A searing indictment from the inside, arguing that the modern health-care industry, unlike almost every other, doesn't disclose its performance or pricing practices to the public and keeps under wraps information about mistakes and substandard quality.†―Laura Landro, The Wall Street Journal“Makary's diagnosis is dangerous, damaging secrecy; his therapy is radical transparency…. [Makary's] argument is powerful…. [he] makes a strong case that the system we have is a disaster for patients.†―Trine Tsouderos, Chicago Tribune Printers Row“A very readable, thought-provoking book that will be of interest to health-care consumers, providers, and legislators. The problems pointed out and the solutions suggested deserve to be part of a national discussion.†―Richard Maxwell, Porter Adventist Hospital Library, Denver, Library Journal“Makary's book makes it perfectly clear that data transparency not only allows people to make informed decisions about their health but also nudges hospitals and physicians to be more vigilant and efficient.†―Tony Miksanek, Booklist“You will be a wiser health consumer for reading this book.†―Michael E Johns, M.D., Chancellor, Emory University“This thought-provoking guide from a leader in the field is a must-read for M.D.s, and an eye-opener for the rest of us.†―Publishers Weekly“Unaccountable is a gripping story about what's wrong with the American healthcare system and what we might do to make it better.†―Peter Pronovost MD, PhD, Executive Vice-President, Johns Hopkins Hospital“Every once in a while a book comes along that rocks the foundations of an established order that's seriously in need of being shaken. The modern American hospital is that establishment and Unaccountable is that book.†―Shannon Brownlee, author of Overtreated“A galvanizing book full of shocking truths about the current state of health care.†―Kirkus Reviews
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About the Author
Marty Makary, M.D., M.P.H. is a surgeon at Johns Hopkins Hospital and a professor of Health Policy at the Johns Hopkins School of Public Health. He is a regular medical commentator for CNN and FOX News, and appears weekly on a wide variety of programs to discuss health topics. Most recently he appeared on FOX News Reporting: BEWARE! DANGER AT THE DOCTOR. He is a leading patient-safety researcher and led the World Health Organization effort to develop ways to measure healthcare quality. He tweets @DrMartyMD.
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Product details
Hardcover: 256 pages
Publisher: Bloomsbury Press; 1 edition (September 18, 2012)
Language: English
ISBN-10: 1608198367
ISBN-13: 978-1608198368
Product Dimensions:
6.4 x 0.9 x 9.6 inches
Shipping Weight: 12.8 ounces (View shipping rates and policies)
Average Customer Review:
4.7 out of 5 stars
303 customer reviews
Amazon Best Sellers Rank:
#164,174 in Books (See Top 100 in Books)
This book was recommended to me by a gentlemen who's elderly mother had brain damaged in her stay in the hospital. Here is my example of what happened. Please forgive me in advance for my writing as it is very difficult for me to leave out information that needs to be there while trying to minimize the actual situation to moments that are significant and forever stuck in my mind. I write this just so people will understand that they must be productive in asking questions and be vocal in what you want to say to the doctor. We made the big mistake of taking the word of the doctor(s) in the beginning because we had no medical experience. In this case of my beloved father, we all lived and slept in that damn hospital everyday 24/7 rotating our shifts. So we were able to see some of the things and the actual time the things happened that tried to be disputed later on.A bad fall in a blizzard sent my otherwise healthy as an Ox father into the ICU. Within days he made huge improvements that surprised the doctors. The physical therapist stated that he doesn't expect him to be with them for long because he was doing so well. The day he was to go to the recovery room my mother noticed he didn't look right. The nurse came by hourly to check on him and look at his levels to put into the computer-- but for some reason she nor any of the doctors failed to noticed that for the past 10 consecutive hours, his oxygen levels kept slipping to dangerous levels. My family asked the nurse to get a doctor because he didn't seem right (the nurse thought he looked fine) but she left and much later (after asking again for a doctor) she came back with a respiratory therapist instead. Soon my father started making weird noises. My brother in law screamed for the doctor. Next thing we know, every doctor rushed into the room and my family were kicked into the hall scared to death. What the hell just happened? He was fine last night! Long story (not so) short: we were told his brain herniated and collapsed! No explanation as to why or how because they had no idea. They actually told me that they had never seen this happen to anyone before. What was also interesting was that every doctor that we saw every day that checked up on him every day made sure to mention to us NOW that they weren't actually his "real" doctor. At the end of that emotionally draining day (and me being in complete denial) I had no idea who his damn doctor was anymore. We requested to have a sit down with the nurse. The head RN said they would interview the young nurse for her point of view of what happened and discuss it with us, however they quickly changed their minds and didn't want to discuss anything anymore. Obviously they were concerned with protecting her. Meetings with the doctors- they told us they felt his cause of death was due to unknown factors but one in which was not related to the injury that brought him to the hospital. They were still at a total loss as to how his brain literally collapsed taking the brain stem with it. They had their "theories" of a stroke or a vasovagal attack, but those where dismissed during the independent autopsy which if anything, was a declaration of how wonderful and strong my father's health had been prior. We were able to find an alternative neurosurgeon doctor from another state look at the reports and he was actually surprised that he saw enough information to declared negligence.When the hospital was taken over by *** I read that all the pursuing changes they made were unacceptable to the established and experienced nurses who, in a short amount of time, all left their jobs for other hospitals. Enter the new nurses, young, inexperienced, and willing to work for what the established nurses would not. This may be an unpopular opinion but during the time when everything seemed to be looking up, I noted how all the nurses in the ICU looked like they were barely out of high school. Why would such inexperienced nurses be in the ICU working alone. I asked each one of them how old they were and how long they were working as a nurse. The average was 22 years old with less than 1 year of experience. Fact is, at that stage you are literally in the entry level stage of you career. I know enough nurses that have told me that at that age they don't have the guts to speak up to a doctor. I want to know why the nurse brought a respritory therapist when we specifically requested a doctor. I also want to know why we had to ask her two times before she brought anyone (yes she did actually left the room making us think she would bring the Dr). Even then, it was my brother in law that screamed and demanded the doctor to come. Then I want to know why she had access to my fathers vitals for the entire night and didn't notice his oxygen levels going down every hour? They won't tell us. 2 years later, we are still suffering without him and we still have so many questions. I feel like I failed him by not moving him to another hospital where I just know in my heart he would have been able to walk out of.--- So for those of you that want to give the professionals the benefit of the doubt -- don't! It's your loved ones so please speak up. Ask questions all the time. My dad came into the hospital with blood in his brain. They were aware of this. The next day the blood was less. I asked about surgery. I was told they would wait to see where it would go. Well it went into a catastrophic event. I look back and wish I begged, demanded, screamed, for them to perform a surgery on my dad. If the blood is there where does it go? His brain swole and that's what caused the herniation.I apologize for carrying on but it's still painful and I don't want anyone to go through what we are going through. It never ends. He's been buried for 2 years but the pain never ends. --- Good luck to everyone out there and tell your family you love them. Better to be cautious than worry that your annoying the doctor.
I am a very recently retired nurse who worked in a university medical center for 38 years. Dr. Makary is telling the truth. When those of us who are committed to patient care and want the best for our patients try to report these untoward practices we are considered "whistle blowers" and are dismissed. Hospitals are now in the business of making money. They don't understand that good practices will save them money. Nor does hospital administration know that spending money on forward thinking staff will save them money. They tell the staff to make out quality reports when something goes wrong but then make no effort to try to correct the situation that caused the error in the first place. Its the health care professionals, nurses and doctors who know what is happening with patients that should be making the decisions, not administrators who haven't even experienced a hang nail and don;t know what it;s like to be on the other side of the clip board. When I started in nursing 43 years ago there were only 500 drugs in the pharmacy formulary. Now there are thousands. Health care in America is a big business now. Our number one gross national product. Sadly those of us who began our careers in health care so long ago have witnessed a culture change that is very hard to watch and be part of. I feel fortunate to have been a part of the old culture and can leave the new culture to a new generation who can hopefully get it back to where it should be.
In 'Unaccountable' Dr. Makary discusses how common sense solutions can fix the healthcare system by empowering patients with information to choose where to go for their medical care. The problem is that the health care industry hides and protects bad doctors, bad practices and bad outcomes.If the public only knew what really goes on, you would be shocked. In my line of work, I am privy to settlements between hospitals and patients who have been harmed. One common element in all these settlements is confidentiality. Nobody can say anything about the lawsuit, the amount of the settlement or anything. How does the withholding of that information help the public? It doesn't.The transparency that Dr. Makary talks about is what is needed. But changing the way medicine is done in the USA won't happen overnight. I highly recommend that everyone read 'Unaccountable' and if you find this of interest another book along the same lines called 'Getting Over Going Under: 5 Things you Must Know before Anesthesia' by Dr. Barry Friedberg which covers his 20+ year struggle to change just one item in health care, i.e. getting hospitals to use a brain monitor during surgery.Hats off to both doctors for shedding light on the health care industry's culturally ingrained obfuscation of the truth and resistance to change.
Not bad. However a few wrong things. First off he gives a lot importance to how an OR runs based on nursing input. I agree that there input is important however I find they can be as obstructive as helpful. For instance a well done operation and successful results depends on keeping the same team together each and every time. Having a different OR team member do one case then a different team member Do the next one etc... then you might not see the same team member for a few months leads to bad outcomes. Ask any surgeon and we would like to keep a core group together for each specialty! However OR mangers seem to mess this up time and time again. This also goes with anesthesia. Keeping the same for each case and each team member. This is why better and best outcomes occur at physician controlled hospitals and surgery centers! Not corporate owned hospitals! No mention of this anywhere in the book! Also the criticism on the DaVinci robot system was true in the beginning but now I think when we look at how it’s being used and outcomes are improving lots of surgical outcomes! So some of the conclusions are a bit outdated
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