Unaccountable

March 27, 2014
BY John Starrels

032814_mishmash_bookBy Marty Makary, M.D.
Bloomsbury Press, 246 pages

Dr. Marty Makary, a surgeon at Johns Hopkins Hospital and an associate professor of health policy at the Johns Hopkins School of Public Health, has written a spell-binding, deeply troubling book on the shameful condition of U.S. hospital care and what steps should be taken to reform it.

Let it be said at the outset: Makary would have done himself and his reading public a great service if he had taken a bit more time to purge the narrative of trite writing such as, in the event of contracting a fatal disease, he would move to the Caribbean and enjoy “what’s left of my days with a pina colada in hand and the sand between my toes.”

Makary’s reform agenda is composed of three overlapping parts: Encourage health consumers (patients) to get second opinions rather than, as is too often the case, meekly accepting the first diagnosis; foster an environment that makes it easier for younger practitioners to challenge the judgments of senior colleagues without fear of retribution; and creating a publicly available information system on “hospital outcomes,” such as the average length of stay for each medical condition or avoidable events that should never happen.

For those of you who are interested in this subject, I would heartily recommend reading this book.

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