With a mix of horrifying medical accidents and warmly logical problem solving, Internal Bleeding
provides a serious, if graphic, look at an industry where a simple mistake can lead directly to death. Happily, authors (both are medical doctors) Robert Wachter and Kaveh Shojania have as many practical solutions as they have tragic errors. Generally based on updated systems and protocols in processes like computerized prescription writing and physically initialing specific body parts to be operated on, their solutions are both sympathetic and angry. Pointing out impatient, overworked or generally stubborn doctors and nurses that are resistant to changing procedures, they also are quick to detail the overwhelming combination of low funds and the drive for profit that keep hospitals from always providing the optimum working (and healing) conditions. Most helpful to nervous patients (and you'll almost certainly be nervous after reading this) is a short chapter offering advice on how to insure you're well informed on all aspects of your health care. While the language--and solutions--presented are often complex, the knowledgeable, personal slant provided by both authors lends a new perspective to the continuing debate between abstract policies and daily practices in health care. --Jill Lightner
From Publishers Weekly
Although the title of this dense book is more than a little alarmist, Wachter and Shojania, professors of medicine at the University of California, San Francisco, convincingly argue that a flawed hospital system, rather than flawed individuals, is responsible for the thousands of deaths that result from medical mistakes each year. Many of the chapters begin with terrifying but now familiar stories of patients who received fatal overdoses of chemotherapy drugs or had the wrong leg removed in surgery. The authors explain that because of the fragmentation of care in modern medicine, errors are often due to communication problems that arise during patient "handoffs." They also point out that medicine lacks the kind of safeguards used in other high-tech industries like the commercial airline business. While acknowledging the many challenges underfunded hospitals face, Wachter and Shojania offer practical solutions, such as using computers to prescribe drugs instead of relying on often-illegible handwritten notes and employing "hospitalists," who are doctors who focus on integrating care between departments and the inpatient and outpatient settings. As a result, their book should satisfy both those seeking gory details about the patient who left the operating table with a sponge in her body and those looking for a thoughtful analysis of this serious public health problem.
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