Unaccountable – by Marty Makary, MD

What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care

If you have ever experienced a total lack of concern by a doctor, a hospital, or both, or just plain incompetence, this book will make you stand up and cheer for the author, and hang your head in shame that our nation can turn a blind eye to such criminal ineptitude. And it is written in clear, plain, readable language by a doctor who was so appalled by what goes on behind closed doors in the health care “industry” that he decided to make a stand, even if it meant being ostracized by his own profession. But to his surprise he found more doctors ready to join his crusade than those who wanted to brand him a traitor.

Dr. Marty Makary, MD, is a practicing cancer surgeon and a professor of public health policy at Johns Hopkins University. He is also a medical commentator for CNN and Fox News networks.

A particularly startling incident is mentioned in reference to a surgeon’s conference that the author attended. Harvard surgeon Dr. Lucian Leape opened the meeting by asking for a show of hands by those who personally knew physicians “who should not be practicing because he or she is dangerous”. Every hand went up. When the author began doing the same in meetings he conducted, he got the same results. Scary, isn’t it? You should read the book. He doesn’t just cite facts and figures. He puts faces to them by telling the very real stories of those who have suffered — and died — because of one thing — the health care industry not being held accountable for their actions, or, in some cases, inactions.

The health care industry, he says, is “not a well-oiled machine, competent and all-wise. It’s more like the Wild West.” He calls it “fragmented”, and “a hodge-podge of rigged, non-standardized care”. And though American medicine is, “in some ways the envy of the world”, as many as 25% of patients are “harmed by medical mistakes“.

He says that “silence about the problem has paralyzed efforts to change the fact of people being injured or killed every day, when some adherence to standardized guidelines would change things”.

What has brought our nation to such a pass that, on the one hand we are held up as a shining example of modern medicine to the entire world, and on the other hand, we hide such a dirty “little” secret?

One reason, says the author, is just plain old greed. “Hospitals no longer have an altruistic mission guide. They have merged and transformed into giant corporations with little accountability . . . corporations that do not abide by the same principles of accountability that govern other industries.” In this respect, he said, hospitals have become like the banks. “Banks wrote their own rules, became unaccountable, and leveraged public risk for private profit.”

Though there are expert reports that gauge the quality of care, says Dr. Makary, the public does not have access to these reports. People unknowingly go into hospitals that have specific “danger zones” — danger zones which that particular hospital has ignored.

Dr. Makary calls American healthcare a “broken system”, and that “discussion of . . . reform has been hijacked by politicians talking in sound bites . . . who oversimplify or misstate entirely”. 

The good news is that there is a movement by doctors and other professionals to change this fragmented and dangerous system by getting it out of the dark, opaque,  secret place it is now. “Transparency’s time has come,” says the author. “It needs common sense reform. We’re talking about people’s lives, here.”

I say a big “Amen” to that, brother.

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