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November 13, 2012 / Leslie

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

Unaccountable: What Hospitals Won't Tell You by Marty Makary, MDUnaccountable: 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.

Source: Borrowed copy from the public library.
© 2012 Under My Apple Tree. All rights reserved.



Leave a Comment
  1. Suko / Nov 13 2012 12:47 pm

    This sounds like an eye-opening book! Excellent review, Leslie!


    • Leslie / Nov 13 2012 7:26 pm

      Some of it is a little disturbing but hopefully by exposing it things will start to change.


  2. The Siren's Tale / Nov 13 2012 5:22 pm

    I would absolutely love to read this book! I worked in healthcare for a little under eight years and was shocked to see what is hidden from patients and families. Did you find any parts of the book disturbing? Sometimes with healthcare, I have this terrible habit of choosing ignorance over being informed, because the realities can be so scary.


    • Leslie / Nov 13 2012 7:19 pm

      It was disturbing because it confirmed much of what I suspected. Having a ‘for profit’ system is at odds with the care portion of the word healthcare.


  3. bibliosue / Nov 13 2012 6:17 pm

    I have this waiting to read on my nook, I think I will take your advice and read it sooner rather than later.
    Another book that may interest you is The Healing of America by T.R. Reid, which is a comparison health services in several other countries to that in the U.S. Fascinating stuff.


    • Leslie / Nov 13 2012 7:25 pm

      Definitely read this. It’s a little shocking to learn that some doctors and hospitals will lie to us so they can make more money, but at the same time good to know so we are sure to do our research rather than just believing what we’re told.

      Thanks for the book suggestion, I’d be interested in reading that one.


  4. therelentlessreader / Nov 14 2012 11:04 am

    This sounds like a GREAT book. It’s fairly well known that out healthcare system is a wreck but I’d really like to know the ins and outs. Thanks so much for this review!


  5. stacybuckeye / Nov 20 2012 8:13 pm

    This would scare me, but you’re right it’s better to read it before you need it!


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