Review: Unaccountable: What Hospitals Won’t Tell You by Marty Makary, MD

Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care
by Marty Makary, MD

Genre: Non-Fiction, Medicine
Publisher: Bloomsbury
Publish Date: September 18, 2012
Format: Hardcover | 256 pages
Rating: 5 of 5

Dr. Marty Makary, a surgeon at Johns Hopkins Hospital and an Associate Professor of Health Policy at the Johns Hopkins School of Public Health, reveals a medical culture of unaccountability in most of our nation’s hospitals. For patients, the healthcare process is not transparent or easy to navigate. Under the current system they have no way of comparing doctors and hospitals, or obtaining statistics on performance. This book is a starting point for healing our broken healthcare system.

In the US, the practice of medicine is one of the most advanced in the world when it comes to drugs, devices and procedures, but we fall behind when it comes to transparency, accountability and patient advocacy. Patients seeking answers and information routinely run into a brick wall of silence. It was my own personal experience advocating for a family member in the hospital which led me to do hours of research and many, many hours of frustration. A low point for the medical system came when a doctor attempted to intimidate me by declaring that I needed to stop asking so many questions, that I was causing a problem and that my mother was happy with his care. Never mind that mom was no longer competent to make those decisions alone.

This is a fascinating, well-researched account and an inside look at what physicians and nurses have known for a long time. As hospitals have merged into giant corporations they have evolved away from the friendly community hospital to a large, for profit institution. I applaud Dr. Makary for breaking the medical culture’s unwritten code of silence and exposing practices that are in place for financial gain and not in the best interests of patients.

Written in an easy to read, engaging style, the book contains many stories and anecdotes about medical school, patients Dr. Makary has treated and doctors he has worked with. He talks about dangerous zones within a hospital, for example a hospital will have a high error rate on a certain procedure but not feel any need to correct it, and dangerous doctors who make too many mistakes but are never held accountable, how in some cases greed can be overpowering and how hospitals pressure doctors to perform by encouraging a high number of procedures per day.

The chapter on drug companies and pharmaceuticals confirms what many of us already know. Drug companies provide bonuses and incentives and practically bribe doctors to prescribe the newest and most expensive products. Chemotherapy drug sales are especially disturbing. The hospitals purchase the drugs and resell them at a high markup; the patient cannot shop for a better price.

Transparency is utmost; patients should never be afraid to ask questions or get a second or even third opinion. The author mentions google and feels it has had a positive impact in empowering patients with information needed to make a good decision. I hope the day will soon be here when we can compare hospital performance and obtain statistics on doctor’s practices. Until then we have to continue asking questions and strive to be an informed consumer.

Read this book now, before you need it.

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Source: Borrowed copy from the public library.
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