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Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care
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Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care

4.24  ·  Rating Details ·  780 Ratings  ·  135 Reviews
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, a ...more
Published September 1st 2012 by Bloomsbury Publishing PLC
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Bernard Farrell
Aug 01, 2012 Bernard Farrell rated it it was amazing  ·  review of another edition
Shelves: medical
Reading this book helped me better understand that surgeons aren't infallible and suggested questions to ask before undergoing any procedure. Marty Makary's book is gripping reading, and the anecdotal stories are outrageous.

I'm hoping enough people will read this and demand hospital produces statistics on surgical outcomes (both good and bad) so we can decide with real information to back our decisions.
Malin Friess
Jan 09, 2013 Malin Friess rated it it was amazing  ·  review of another edition
When Dr. Makary MD (general surgeon) told his friends he was going to write this book they said, "Your colleagues will hate you." But after publication, Dr. Makary found just the opposite, as physician after physician told me this story needs to be told. I agree.

Dr. Makary quit medical school as third year intern after he watched a sweet elderly lady die after a procedure she didn't need. He enrolled in the Harvard School of Public Health; to study the science of measuring quality. After 6 years
Mar 01, 2014 Kevin rated it it was amazing  ·  review of another edition
Shelves: non-fiction
I met Dr. Makary at the HIMSS 2014 Conference in Orlando last week where he spoke on this topic (and held a book signing). His speaking is just as engaging and motivating as his writing. Overall, transparency, I agree, is a good thing and will go a long way toward improving patient safety.

One of the things to look out for: gaming the system. Dr. Makary makes the point in the last chapter (p. 213) that "Doctors understand the science and have developed non biased methodologies for tracking quali
Sep 19, 2012 Linda marked it as to-read  ·  review of another edition
I am hoping to read this book very soon. I keep saying that health insurance costs are not the only or biggest problem with our health care problems in this country. While we are blessed to have some of the best doctors in the world in the United States, we also have a lot of bad doctors that are making mistakes and getting charged with malpactice...therefore WE are being charged with malpactice as doctors and hospitals pass a lot of those costs on to patients. I am looking forward to this book ...more
Missy Caulk
Jan 05, 2013 Missy Caulk rated it it was amazing  ·  review of another edition
I just finished this book and I commend the author for writing it. I'm sure he had a lot of his fellow physicians up in arms. I recommend it to everyone before going into the hospital for surgery, as it contains the right questions to ask, who to ask and who to look for for second opinions.
Dr Makary has great ideas on how to make Dr.'s and hospitals more accountable for their outcomes. It will be interesting to see if any hospitals adopt "any" of the suggestions.
Jul 02, 2017 Christy rated it it was amazing  ·  review of another edition
Definitely opened my eyes. It's imperative to inquire and question when it comes to your health - no more blind trust in doctors (or anyone). Transparency would be transformational for our healthcare system. If only that was the topic being debated right now.
Oct 26, 2012 Jerry rated it really liked it  ·  review of another edition
Shelves: science
This book is well worth reading to learn about some very sensible proposals for improving and reducing the cost of health care. The key point is transparency.

“Congress should make transparency a condition of Medicare reimbursement and other funding.” Transparency includes “public reporting of outcomes, disclose all conflicts of interest, streamline patient access to records, and disclose mistakes as soon as they learn about them... By doing so, it will unleash the power of the free market to cre
Alarming. Clear. Many stories of bad practices. Too many. Yay Mayo. Boo children's hospitals. Surprising how little power doctors felt they possessed to affect change that would benefit the patient within their own workplace. Avoiding hospitals like the plague does not sound so crazy after all. Author makes good recommendation to demand transparency from hospitals and also from legislators if the medical institutions are receiving federal funds.
Dec 26, 2012 Vertrees rated it did not like it  ·  review of another edition
I am completely appalled at the section on Walter Reed. The gross inaccuracies, misleading information, and lack of attention to detail of that section casts the entire book in doubt.

See for yourself- search for the Washington Post article (search Google for 'Walter Reed Washington Post 2007'- I found it in under a minute). If you *read* the article, you will see that there were two major problems reported- the *offpost* housing and overly bureaucratic process.

My second problem- Dr. Marohn was
Oct 22, 2013 Dan rated it really liked it  ·  review of another edition
Dr. Makary says that transparency is the key to reducing the cost of health care in the US and improving the areas in which US health care has results worse than many other countries. Driven by the profit motive and free from any scrutiny by patients or the general public, hospitals have reacted to maximize profit rather than patient welfare. He cites such problems as incompetent doctors (all medical students pass medical school regardless of grades), impaired doctors (those under the influence ...more
Oct 02, 2013 Rachel rated it really liked it  ·  review of another edition
On hearing that 20% or more of patients encounter complications caused by their medical treatment or hospital stay, one might wonder how individual hospitals and the medical-industrial complex could afford to ignore the statistic--and why more patients aren't up in arms about the obstacles to evaluating the quality of their treatment. In fact, as Dr. Makary discusses, this is one logical consequence of a system that makes up a fifth of the nation's economy yet goes largely untaxed and unregulate ...more
The author is an oncologist at John Hopkins. He talks about dr. Hadad (Hands of Death and Destruction) there are quite a lot in our system. It tells horror stories of doctors that are reckless and treat their slept patients as garbage. They rely on the blissfulness amnesic powers of the anesthesia and know that the patient won't remember a thing of the mistreats they are subjected to. Doctors have no heart. They have big wallets in the middle of their chests; but sometimes the system starves tho ...more
Andd Becker
Feb 26, 2013 Andd Becker rated it really liked it  ·  review of another edition
Transparency in government needs to be accompanied by transparency in the medical field. There are certain things a patient needs to know, such as was your surgeon on call the night before, and did he or she get enough sleep.
I would never think of asking that if I were going in for elective surgery. But maybe if I read the book again, I'd be more savvy.
I recall when my mom was hospitalized for surgery to correct a surgeon's inexpertise in setting a collarbone. Mom looked at the new surgeon's nam
May 07, 2013 Ethan rated it really liked it  ·  review of another edition
Compelling - if occasionally disjointed - case for how transparency of hospital quality and outcomes metrics could greatly improve health care in the USA.

Skirts any mention of cost transparency, also omits describing how most doctors are not actually employees of the hospitals he proposes making more accountable.

But the descriptions of nascent efforts in quality reporting are powerful, along with the idea that health care can only get better - and quickly! - when consumers are empowered with i
Sharon Dewit
Feb 26, 2013 Sharon Dewit rated it it was amazing  ·  review of another edition
Amazing to read. Talks about how robotic surgery is NOT an improvement. Talks about how little we really know about our hospitals and how in the dark we are. Discusses things that will make you angry and sad. How have we allowed medical care to be about the dollar and not the patient? Why should we ever allow this to continue? A must read for anyone who might ever be a patient or the loved one of a patient. Wish it was required high school reading!
Jun 04, 2013 Emily rated it it was amazing  ·  review of another edition
Shelves: md-to-be
Between my summer experiences and this book, my med student idealism has been thoroughly and vitally smashed. But from the pieces, I find myself now able to better construct a new and realistic outlook on the current state of medicine as well as where I'd like to take it in my future practice. This is an important book for anyone in the medical profession, as well as anyone interested in having the tools to be their own best advocate as a patient.

Nov 03, 2012 Deann rated it it was amazing  ·  review of another edition
I was impressed by level of honesty expressed by Dr. Makary. It was well-written and exposed the dreadful situation in many American hosptials. This book has the potential to be our generation's The Jungle; it is a wake up call to make our hospitals safer and more transparent about how our healthcare and taxpayer dollars are spent. A must-read for anyone before undergoing any major medical treatment!
Geoffrey Rose
Apr 26, 2013 Geoffrey Rose rated it really liked it  ·  review of another edition
A call to arms for greater transparency in health care. A solid primer on the importance of better patient safety culture for the health care professional and general reader alike. Strongly recommended.
Oct 03, 2012 Pamela rated it really liked it  ·  review of another edition
4.75 excellent

As captivating as a thriller and highly informative. A tipping point is imminent and full disclosures of practices in medicine will result in saved lives, reduced costs and the integrity of a serving profession.

I highly recommend this book.
Rebecca Tan
Oct 14, 2012 Rebecca Tan marked it as to-read  ·  review of another edition
A book that leads you to question the very core and motivation of modern medicine. Insightful read on ethical issues in public health care, pointing to a need for reform.
As seen in Nature .
Sep 25, 2012 Danielle marked it as to-read  ·  review of another edition
Shelves: society
Heard the author interviewed on NPR's Diane Rehm show and he was really impressive - his book is a Must Read.
Sep 19, 2012 Megan rated it it was amazing  ·  review of another edition
Shelves: non-fiction
Fascinating read about hospital culture and the need for change.
Jessica Santos
Oct 02, 2012 Jessica Santos rated it really liked it  ·  review of another edition
A must-read for any health care consumer or affiliate. Books like these will help change our broken health care system into something better.
Sep 21, 2012 Elise rated it it was amazing  ·  review of another edition
Excellent......everyone should read this.....
Nov 20, 2012 Stacy marked it as to-read  ·  review of another edition
it's leslie's fault.
Sep 28, 2012 Joe rated it it was amazing  ·  review of another edition

Selected quotes:

"...frustrated by two trends in modern medicine: 1) hospital administration being increasingly removed from daily hospital care, and 2) modern medicine's growing appetite to over-screen, over-diagnose, and over-treat."

"...the reason there was no business case for his plan to lower complications was that hospitals profit from bad medical care. He realized that hospitals get more money for each complication, X-ray, and extra patient day in the ICU. One well-known national study
Cameron Hilt
May 21, 2017 Cameron Hilt rated it it was amazing  ·  review of another edition
I couldn't have picked up this book at a more pivotal time in my life. I was weighing out what direction I wanted to take my career in healthcare. Not only has this book shown me the tragic reality of our medical system today; but it also has inspired me to pursue a career where I can work to make it better. To bring our healthcare back to its original purpose. To protect and care for the patients who enter a hospital's doors from start to finish.

He draws in interesting stories from his own exp
Jun 30, 2017 Megan rated it really liked it  ·  review of another edition
Shelves: medicine
4.5 stars

This book is a must read for all those interested in being more informed about their healthcare. Dr. Makary outlines different questions patients can and should ask to increase transparency in their care. It was disappointing to read many of the stories and statistics regarding how some hospitals/doctors favor lining their own pockets over their patients' health. However, the book ended on an encouraging note, suggesting that the new generation of physicians will usher open-mindedness a
May 28, 2017 Kathy rated it really liked it  ·  review of another edition
Since this book was written there have been some small strides for transparency but it is still very difficult to know how safe and competent a doctor or hospital is. This is a big problem as we move to more consumer driven healthcare. This book addresses the problem of how is the consumer supposed to judge the quality of the healthcare. The answer is we really can't today (which isn't a spoiler if one has had to deal with the healthcare system). The author proposes some basic solutions to this ...more
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Dr. Makary is a surgeon and researcher at Johns Hopkins University School of Medicine. He is the author of Unaccountable by Bloomsbury Press and a national advocate for transparency in health care.

Dr. Makary was the lead author of the original publications on the surgery checklist which he and Dr. Pronovost adapted from their experience with patient safety in the ICU. He subsequently served in lea
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“U.S. surgeons operate on the wrong body part as often as 40 times a week.” 1 likes
“Just as the financial crisis was incubated when unaccountable bank executives created a culture of rewarding short-term profits without wanting to know the ugly details about their mortgage-backed securities, so too does medicine’s lack of accountability create an institutional culture that fosters overtreating and runaway costs.” 0 likes
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