Unaccountable: What Hospitals Won’t Tell You and How Transparency can Revolutionize Healthcare by Marty Makary
Genre: General Educational Nonfiction
tl;dnr Book Stats
Themes: healthcare in America, transparency and accountability policies, public health research studies, the role of physicians and patients, writing with an agenda
Recommended Reads…: T.R. Reid’s The Healing of America is a good and simplistic crash course in healthcare systems comparison. Atul Gawande’s The Checklist Manifesto is itself about Dr. Makary’s surgical checklist idea to reduce operation complications.
Why I chose to read this…: In researching what to expect prior to my visit to the medical school at Johns Hopkins, I ran across a forum member mentioning this book by a Hopkins surgeon. I eventually picked it up to read because I thought it would be best to be prepared and informed as possible about the current American medical landscape.
Just this week, I ran into and chatted with a physician-scientist with whom I had worked three years ago. Chitchat aside, I was struck by his honesty regarding his career as a hospital-research institution-employed academic MD/PhD and what he saw America’s healthcare and medical system becoming. It was a dismal outlook, a dire situation. In his words, America is “creaking and hobbling around and totally blind to how crippled its healthcare is.” He’s not being pessimistic. I completed reading Makary’s Unaccountable shortly after speaking with my mentor, and the stories and statistics about hospital administration Makary lays out are reflective of his as well as many healthcare professionals’ complaints and concerns.
Makary presents readers with a wealth of eye-opening information, but sometimes it can be repetitive. I will list some bits that I thought were most shocking and/or most valuable for current and future physicians and policy-makers to tackle.
- Hospitals are businesses (okay, this isn’t that shocking…). Doctors, especially surgeons and those who perform procedures, are usually paid on a per-operation “eat what you kill (or cut open)” basis. Therefore, patients are more likely to be pushed to accept more and drastic procedures that prolong their hospital stays.
- Some doctors don’t care. They don’t care about the patients’ best interests or issues raised by those underneath them, such as nurses, residents, trainees. Interns who whistle-blow or try to rock the boat see their careers derailed.
- It will do well for patients to always ask for second opinions and do some research prior to consultations. Google is your best friend.
- Makary’s main underlying point of his book is advocating for increased transparency in the healthcare sector…well, namely in hospitals where the bulk of complications arise. Information is one of the field’s most precious commodities, and patients and other healthcare professionals should have access as much as physicians and healthcare administrators (who, according to my mentor, are mostly MBA holders rather than a physician of any kind) do.
All in all, Unaccountable was a honest horror story that might just be worse than Stephen King’s fare. I mean, this stuff is happening right now in this country, and, as a result, money and health are both slipping through the cracks. I’d recommend this book to anyone entering medicine to get a picture of the dark sides of American healthcare.
Rating: Leaves a Lasting Impression