Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care
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"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
Dr. Marty Makary is co-developer of the life-saving checklist outlined in Atul Gawande's bestselling The Checklist Manifesto. As a busy surgeon who has worked in many of the best hospitals in the nation, he can testify to the amazing power of modern medicine to cure. But he's also been a witness to a medical culture that routinely leaves surgical sponges inside patients, amputates the wrong limbs, and overdoses children because of sloppy handwriting.
Over the last ten years, neither error rates nor costs have come down, despite scientific progress and efforts to curb expenses. Why? To patients, the healthcare system is a black box. Doctors and hospitals are unaccountable, and the lack of transparency leaves both bad doctors and systemic flaws unchecked. Patients need to know more of what healthcare workers know, so they can make informed choices. Accountability in healthcare would expose dangerous doctors, reward good performance, and force positive change nationally, using the power of the free market.
Unaccountable is a powerful, no-nonsense, non-partisan diagnosis for healing our hospitals and reforming our broken healthcare system.
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Marty Makary. (2012). Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care. Bloomsbury Publishing.
Chicago / Turabian - Author Date Citation (style guide)Marty Makary. 2012. Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care. Bloomsbury Publishing.
Chicago / Turabian - Humanities Citation (style guide)Marty Makary, Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care. Bloomsbury Publishing, 2012.
MLA Citation (style guide)Marty Makary. Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care. Bloomsbury Publishing, 2012.
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- bioText: Dr. Marty Makary is a professor at the Johns Hopkins School of Medicine and Bloomberg School of Public Health and the author of the New York Times bestseller, Unaccountable. He is a leading voice for physicians in The Wall Street Journal, The New York Times, and USA Today, and is Editor-in-Chief of Medpage Today. Marty has published extensively on medical innovation, quality measurement, special issues of vulnerable populations, and health care costs. He served in leadership roles at the W.H.O. and has been elected to the National Academy of Medicine. He leads several national grants on health care transparency and the re-design of health care. Marty is the chief of the Johns Hopkins Center for Islet Transplantation Surgery and is the recipient of the Nobility in Science Award from the National Pancreas Foundation. Previously he served as founding director of the Johns Hopkins Center for Surgical Trials and Outcomes Research. Marty currently serves as chair of the advisory board of African Mission Healthcare. He lives in the Washington, DC area.
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"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
Dr. Marty Makary is co-developer of the life-saving checklist outlined in Atul Gawande's bestselling The Checklist Manifesto. As a busy surgeon who has worked in many of the best hospitals in the nation, he can testify to the amazing power of modern medicine to cure. But he's also been a witness to a medical culture that routinely leaves surgical sponges inside patients, amputates the wrong limbs, and overdoses children because of sloppy handwriting.
Over the last ten years, neither error rates nor costs have come down, despite scientific progress and efforts to curb expenses. Why? To patients, the healthcare system is a black box. Doctors and hospitals are unaccountable, and the lack of transparency leaves both bad doctors and systemic flaws unchecked. Patients need to know more of what healthcare workers know, so they can make informed choices. Accountability in healthcare would expose dangerous doctors, reward good performance, and force positive change nationally, using the power of the free market.
Unaccountable is a powerful, no-nonsense, non-partisan diagnosis for healing our hospitals and reforming our broken healthcare system. - reviews
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- content: The problems he describes are real and disturbing . . . Dr. Makary argues that true reform will only come with full disclosure.
- premium: False
- source: Chicago Tribune
- content: Makary's diagnosis is dangerous, damaging secrecy; his therapy is radical transparency . . . [His] argument is powerful . . . [He] makes a strong case that the system we have is a disaster for patients.
- premium: False
- source: Peter Pronovost MD, PhD, Executive Vice-President, Johns Hopkins Hospital
- content: Unaccountable is a gripping story about what's wrong with the American healthcare system and what we might do to make it better.
- premium: False
- source: Peter Boyer, Senior Correspondent for Newsweek
- content: 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.
- premium: False
- source: Michael E Johns, M.D., Chancellor, Emory University
- content: This book should be read by all people, not just doctors and health administrators, so they can make wise decisions when it comes to choosing where, when and who will provide healthcare for themselves and their loved ones. You will be a wiser health consumer for reading this book.
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June 11, 2012
We demand accountability from Wall Street and the White House, yet are shockingly reluctant to demand it from our hospitals, laments Makary, a Johns Hopkins surgeon and professor of health policy, in this urgent call for doctors and hospital administrators to ditch their dangerous culture of secrecy. Lifting the veil on the existing wealth of data from hundreds of hospitals’ rates of infections, surgical complications, and other negative patient outcomes, he argues that making those statistics public would force low performers to fix their problems and compete far more effectively rather than waste money on ad campaigns. Moreover, every patient should routinely be able to see a hospital’s re-admission rate; its surgical or treatment complication rates; its “never happen” events, like surgery on the wrong side of a patient; its safety-survey scores from its own workers; its volume of operations and treatments; and its programs to streamline access to patient records. For a noteworthy example, Makary dishes that one patient boasted that his surgeon operated on President Reagan—but had no clue Reagan suffered from complications caused by an improperly placed central-line for IV fluids and medication. 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. Agent:Glen Hartley, Writer’s Representatives LLC.
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July 1, 2012
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.COPYRIGHT(2012) Kirkus Reviews, ALL RIGHTS RESERVED.
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April 15, 2012
The Johns Hopkins surgeon who developed the checklist that inspired Atul Gawande's best-selling The Checklist Manifesto, Makary here challenges the lack of transparency in health care, which leaves patients ignorant and error rates uncomfortably high despite efforts to curb them.
Copyright 2012 Library Journal, LLC Used with permission.
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"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
Dr. Marty Makary is co-developer of the life-saving checklist outlined in Atul Gawande's bestselling The Checklist Manifesto. As a busy surgeon who has worked in many of the best hospitals in the nation, he can testify to the amazing power of modern medicine to cure. But he's also been a witness to a medical culture that routinely leaves surgical sponges inside patients, amputates the wrong limbs, and overdoses children because of sloppy handwriting.
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