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Internal Bleeding: The Truth Behind America's Terrifying Epidemic of Medical Mistakes Hardcover – May 10, 2005

24 customer reviews
ISBN-13: 978-1590710739 ISBN-10: 1590710738

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Editorial Reviews Review

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 --This text refers to an out of print or unavailable edition of this title.

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.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to an out of print or unavailable edition of this title.

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Product Details

  • Hardcover: 441 pages
  • Publisher: Rugged Land (May 1, 2005)
  • Language: English
  • ISBN-10: 1590710738
  • ISBN-13: 978-1590710739
  • Product Dimensions: 5.9 x 1.5 x 9.1 inches
  • Shipping Weight: 1.6 pounds
  • Average Customer Review: 4.3 out of 5 stars  See all reviews (24 customer reviews)
  • Amazon Best Sellers Rank: #722,138 in Books (See Top 100 in Books)

More About the Author

Robert Wachter is Professor and Interim Chair of the Department of Medicine at the University of California, San Francisco. He coined the term "hospitalist" and is considered the father of the hospitalist field, the fastest growing medical specialty in modern times. He is past president of the Society of Hospital Medicine, and past chair of the American Board of Internal Medicine. In 2015, Modern Healthcare magazine named him the most influential physician-executive in the U.S.

His new book is "The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age." The New York Times called it "Eloquent...powerfully felt & intelligently analyzed." Abraham Verghese called it "simply brilliant" and Atul Gawande said, "I kept thinking, 'Exactly!' while reading it, and that is a measure of Wachter's accomplishment in telling the tale." In April, 2015, it reached the Times science bestseller list.

He and his wife, the author and journalist Katie Hafner, live in San Francisco.

Customer Reviews

Most Helpful Customer Reviews

35 of 37 people found the following review helpful By Monica J. Kern VINE VOICE on April 28, 2004
Format: Hardcover Verified Purchase
I strongly suspect that the publishers insisted on the title of this book over the objections of the authors, because (as another reviewer has noted) the title is clearly sensationalistic and very much out of line with the even-handed and level-headed treatment of the rest of the book. Indeed, the title is perhaps the ONLY thing I would criticize about this otherwise excellent and gripping description of the underlying causes of medical mistakes and what can be done about them.
I cannot praise the quality of the writing enough. The authors accomplish just the right blend of fascinating case studies and theoretical analysis. They make their basic point (that any system run by humans is fallible and medical mistakes are inevitable) very effectively in the beginning pages of the book by describing two case studies where mistakes were made...with the punch line being that the mistakes were committed by the authors themselves. Beginning the book this way was in part so effective because it gets across the message that the vast majority of mistakes that are made are not the result of negligent, careless, or malicious physicians; rather, they are the inevitable consequence of a system that struggles to cope with the complexity of the ever-changing demands of a never-ending stream of patients.
The second most admirable feature of this book, in my opinion, is that it does not merely criticize but also offers suggestions for improving the delivery of medical services to eliminate errors, from such simple steps as physicians "signing their sites" (to prevent, say, amputation of the wrong limb) to computerizing medication orders (to prevent errors due to physicans' notoriously poor handwriting) to more systemic changes in malpractice law.
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17 of 20 people found the following review helpful By Amazon Customer on February 20, 2004
Format: Hardcover
I highly recommend this book!
I first saw Dr. Wachter on IMUS. The interview was terrific. Not only was the subject matter interesting, the doctor spoke in a language anyone could understand, and he was funny to boot. He made a great analogy about calling his favorite Chinese take-out restaurant to place an order. Before they hung up, they repeated the order back to him (like the world would end if he got the wrong kind of soup), but nurses and pharmacists have not been trained to do the same when a prescription is phoned in. The just say thanks to the doctor and hang up.
Well, I immediately bought the book and could not put it down. So many of these types of books speak to other medical personnel, this one is for everyone. I have recommended it to my book club (15 suburban Moms) and the discussions have been quite interesting. We all have our own stories to share about the medical process. Who doesn't have a story about a doctors appointment with an ailing parent or a 2:00am emergency room visit with their toddler? I now feel better equipped to deal with these situations.
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12 of 14 people found the following review helpful By A Customer on February 9, 2004
Format: Hardcover
Nearly every disease or medical condition has a group that works to bring attention to the importance of spending time and money to understand and control it. A key activity for these groups is to bring the disease to the attention of the public in an effort to influence the flow of money and talent to their cause. Some diseases affect such a small number of people that it is impossible to reach a critical mass of affected or interested people to be able to influence politics or market forces. Others may affect a large number of people, but fail to receive the support of the public and those that fund research. In the 1980s AIDS was in this latter category until the a critical mass of activists took up the cause and moved it high on the list of diseases receiving support from federal sources, private industry (pharmaceutical companies), and the public at large.
In the last few years it has become it has become clear that medical errors can be thought of as an epidemic (though not a new one) needing the same kind of support that led to significant improvements in the transmission and treatment of AIDS 15 years ago. There have been a number of reports about the problem in the medical and lay press, but it remains a disease that doesn't yet have many energetic and vocal activists. Internal Bleeding may change that.
Wachter and Shojania have written an entertaining and easy to read overview of the problem, including the work done by a handful of very talented researchers to understand the root causes and potential solutions. It is full of anecdotes of medical mistakes with a more thoughtful analysis of them than what one can learn from the newspaper or nightly news. The book is likely to engage the public more than previous academic reports and TV news segments. It may move medical mistakes and healthcare quality overall, up on the list of our nation's priorities more successfully than other efforts to date.
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19 of 24 people found the following review helpful By A Customer on January 21, 2004
Format: Hardcover
A fearless and eye-opening look at the terrible mistakes that occur in medical settings. Not just a collection of horrific anecdotes (though there are PLENTY of those.) There are REAL solutions set forth here and I hope someone is paying attention. To their credit, the authors reveal what lay people have never before been privy to--some of which falls into the "Yikes! Maybe ignorance really IS bliss" category, but makes for engrossing reading.
I could not put it down until the last page. This should be required reading for policymakers and potential patients alike.
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