UNACCOUNTABLE by Martin Makary


What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care
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A searing insider's look at what really goes on behind the scenes at major hospitals and how implementing simple steps toward transparency can empower patients and dramatically improve the culture and safety of health care.

Makary, a cancer surgeon and professor of health policy at the Johns Hopkins Bloomberg School of Public Health, states in no uncertain terms that medical errors are a nationwide problem affecting thousands of unwitting patients. Often, hospital management operates on corporate models, pursuing profit over quality, resulting in overprescribed procedures and rushed or sloppy surgeries. Despite efforts to make medical care safer, a quarter of all patients in America are harmed by medical mistakes, a statistic that persists largely due to the "code of silence" that exists among doctors. The author argues that transparency, both within hospital personnel and between hospitals and the public, has the potential to radically decrease instances of preventable errors and to eliminate incompetent doctors. For example, making doctor's notes part of a shareable database of medical records increases accountability and allows patients to make more informed decisions about their health. Similarly, requiring hospitals to tally and share mortality rates for standard surgeries leads to quick improvements in practices. When a hospital's reputation is on the line, and potential patient dollars are at stake, the impetus to improve becomes significant. When New York state tried this tactic using heart-surgery death rates, the result was "big, broad improvements in mortality, statewide. With each passing year of public reporting, the state’s average death rate went down.” Providing an abundance of hospital-reported data alongside eye-opening anecdotes, Makary gives practical tips on how to navigate the system and receive quality care. However, he insists that without dramatic—though easily implemented—changes, little will improve.

A galvanizing book full of shocking truths about the current state of health care.

Pub Date: Sept. 18th, 2012
ISBN: 978-1-60819-836-8
Page count: 256pp
Publisher: Bloomsbury
Review Posted Online:
Kirkus Reviews Issue: July 1st, 2012


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