EagleTribune.com, North Andover, MA

September 23, 2012

'Unaccountable' is a thought-provoking read

Terri Schlichenmeyer
Correspondent

---- — You’re trying hard not to be scared.

You really weren’t surprised when the doctor said you needed an operation. It was kind of expected but let’s face it — you’re nervous, even though you know you’re in good hands.

But are you? How does your hospital rate for safety and employee satisfaction?

Believe it or not, the hospital doesn’t want you to have that information, but in the new book “Unaccountable” by Marty Makary, M.D., you’ll see how transparency could make a difference in your health.

When you chose your personal physician, you probably had many reasons for settling on that one person. Maybe he came with a good recommendation from friends. She might have been a referral from another doctor. But how do you know you got the right doctor for you?

The truth is, you may never know. Hospitals, says Makary, pay good money to ensure that internal surveys on teamwork, safety, adherence to policy, mortality, infections and more never become public. What’s more, doctors are loathe to sound the alarm on a colleague’s incompetence because doing so is career suicide. Honesty and outspokenness can get a doctor “run out of town,” and though it’s assumed that the State Board will handle an issue, Makary says it’s not always what happens.

What he recommends is transparency.

If hospitals allow the public to know where internal problems lie and where money is invested, that knowledge gives prospective patients the power to change the system for the better by patronizing institutions that are doing things right. Hospitals with poor performance scores will be forced to rise to the challenge and improve.

Transparency, he says, worked in New York ‘s heart centers. It could work everywhere.

In the meantime, there are things you can do to help yourself when you need medical care.

Be aware of clever marketing and don’t let a flashy website keep you from asking questions. Use your right to a second (or third) opinion, even if you have to pay for it yourself. Know what kind of doctor you need and pick one who’s done a lot of the kind of care you require. And finally, before you settle on a surgeon, ask other healthcare workers who they’d choose for their healthcare.

That, says Makary, “… tells you everything.”

Sobering, thought-provoking, and wonderfully entertaining, “Unaccountable” is also very controversial. And, according to author Marty Makary, it’s something many of his fellow physicians thanked him for writing.

Using his own experiences and observations as examples for his ideas, Makary sharply illustrates how bad medicine can have tragic outcomes and what can be done about it. Readers will surely be shocked — and frustrated because of the code of silence that Makary describes in dismaying detail and because he offers ample reasons behind why the cost of getting you healthy will make you absolutely sick.

If healthcare is on your mind in this politically-divisive year, then “Unaccountable” will give you more food for thought. For you, this book on medical transparency is clearly something you’ll want to read .

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Terri Schlichenmeyer reviews books for the Sunday Eagle-Tribune.

"Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care" by Marty Makary, MD c.2012, Bloomsbury Press $26.00 / $27.50 Canada 246 pages