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Marty Makary MD
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Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care MP3 CD – MP3 Audio, April 22, 2013

by M.D. Makary, Marty (Author), Robertson Dean (Narrator)
4.7 4.7 out of 5 stars 748 ratings
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Dr. Marty Makary is codeveloper 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, amputates the wrong limbs, and overdoses children because of sloppy handwriting. Over the last ten years, neither error rates nor costs have come down, despite scientific progress and efforts to curb expenses. Why? To patients, the healthcare system is a black box. Doctors and hospitals are unaccountable, and the lack of transparency leaves both bad doctors and systemic flaws unchecked. Patients need to know more of what healthcare workers know, so they can make informed choices. Accountability in healthcare would expose dangerous doctors, reward good performance, and force positive change nationally, using the power of the free market. Unaccountable is a powerful, no-nonsense, non-partisan diagnosis for healing our hospitals and reforming our broken healthcare system.
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  1. Language
    English
  2. Publisher
    Tantor Media Inc
  3. Publication date
    April 22, 2013
  4. Dimensions
    5.3 x 0.59 x 7.4 inches
  5. ISBN-10
    1452662916
  6. ISBN-13
    978-1452662916
  7. See all details
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The Amazon Book Review
Book recommendations, author interviews, editors' picks, and more. Read it now

Editorial Reviews

About the Author

Marty Makary, M.D., is a surgeon at Johns Hopkins Hospital and a professor of health policy at the Johns Hopkins School of Public Health.
Robertson Dean has recorded hundreds of audiobooks in most every genre. He's been nominated for several Audie Awards, won nine Earphones Awards, and was named one of AudioFile magazine's Best Voices of 2010.

Product details

  • Publisher ‏ : ‎ Tantor Media Inc; Unabridged edition (April 22, 2013)
  • Language ‏ : ‎ English
  • ISBN-10 ‏ : ‎ 1452662916
  • ISBN-13 ‏ : ‎ 978-1452662916
  • Item Weight ‏ : ‎ 3.2 ounces
  • Dimensions ‏ : ‎ 5.3 x 0.59 x 7.4 inches
  • Customer Reviews:
    4.7 4.7 out of 5 stars 748 ratings

About the author

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Marty Makary MD

Marty Makary MD

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Dr. “Marty” Makary is a Johns Hopkins professor and 3-time NYT bestselling author. His newest book, BLIND SPOTS looks at the latest scientific research on topic that we are not talking about (that we need to talk about):

▶ The Microbiome

▶ Hormone Replacement Therapy

▶ The Peanut Allergy Epidemic

▶ Eggs (& Food)

▶ Blood tests not being ordered everyone needs

▶ Childbirth

▶ Cancer Prevention

▶ Marijuana

▶ The Culture of Medicine

▶ Medical Dogma

Dr. Makary has been a visiting professor at over 25 medical schools, has published over 300 scientific peer-reviewed articles, and has written for the Wall Street Journal, the New York Times, and the Washington Post. A public health researcher, Dr. Makary served in leadership at the World Health Organization and is a member of the National Academy of Medicine.

Dr. Makary is the recipient of the 2020 Business Book of the Year Award for his book, The Price We Pay, about the grassroots movement to lower healthcare costs through greater medical transparency. He currently leads the Evidence-based Medicine Public Policy Research Group at Johns Hopkins and is director of The Re-design of Healthcare Project, a national effort to make health care more reliable and affordable, especially for vulnerable populations. His research focuses on the appropriateness of medical care, administrative waste, and the impact of health recommendations on society. Dr. Makary is the recipient of the Nobility in Science Award from the National Pancreas Foundation and numerous teaching awards. His newest book, Blind Spots, details how to live healthy by separating medical dogma from evidence-based science.

Customer reviews

4.7 out of 5 stars
748 global ratings

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Customers say

Customers find the book insightful and thought-provoking. They praise the writing quality as credibly written and clearly stated. The information provided is praised as great, with potential answers to improving health care and cutting costs. Readers appreciate the transparency and raw look inside the American medical system. However, some feel the lack of accountability is a major drawback.

AI-generated from the text of customer reviews

Select to learn more
ReadabilityThought provokingWriting qualityInformation qualityTransparencyLookStory qualityAccountability
110 customers mention "Readability"110 positive0 negative

Customers find the book easy to read and engaging. They consider it a valuable resource for health care professionals, systems thinkers, and CQI professionals. The book is described as refreshing and honest, making it a must-read for HR and benefits staff.

"...Thank you for making this wonderful (if hard to listen to) book available and thank the writer especially. Nancy (and John) Morse" Read more

"...Whatever...a good book, which I would reccomend." Read more

"...This is an important book by Dr. Makary given that so few have been willing to speak out heretofore...." Read more

"good book" Read more

107 customers mention "Thought provoking"105 positive2 negative

Customers find the book insightful and helpful. It provides concrete suggestions about researching hospitals for various types of procedures. The author does a nice job covering a difficult subject, and the solutions offered provide a glimpse of hope for transparency in the medical industry.

"...What strikes me over and over again is the importance of culture at hospitals...." Read more

"Frightening and very real...." Read more

"...The most telling parts of the book are when Makary describes how he himself was treated when his brother was hospitalized (as a nuisance) and how..." Read more

"...book are quite funny for the surgeon reader, and likely very shocking to the lay reader...." Read more

55 customers mention "Writing quality"48 positive7 negative

Customers appreciate the book's writing quality. They find it credibly written by a doctor who has spent his career within the system. The content is clearly stated and insightful. Readers praise the author for having the courage to write and publish this information. The book is a must-read for healthcare professionals, honest, and well-written with no typos or grammatical mistakes.

"...It is wonderful that the author has the courage to write and publish this information and it ought to be given as a gift by all of us to those we..." Read more

"Frightening and very real...." Read more

"...The book is very well written; I saw no typos or grammatical mistakes; the subtopics are nicely compartmentalized into chapters; the subtopics are..." Read more

"...The measures Dr. Makary advocates are simple, sensible and doable...." Read more

28 customers mention "Information quality"23 positive5 negative

Customers find the book provides useful information about patient safety and health care. They say it offers common-sense solutions to problems in the medical system. The book integrates well with the concepts and observations in Gawande's The Checklist and helps readers get the best and safest medical care.

"...clinic are so highly regarded and how they come about having a great safety culture...." Read more

"This book is worth reading for health care professionals, systems thinkers, CQI professionals, health policy experts, politicians, and the general..." Read more

"...The good news is some adverse events are 100% preventable...." Read more

"...So much helpful and alarming information about our health care system and written by a very repected doctor and surgeon...." Read more

10 customers mention "Transparency"10 positive0 negative

Customers appreciate the transparency in the book. They say it's a candid report on what really happens in hospitals. The book does them a great service by exposing and explaining the ins and outs of health care.

"...I wish Dr. Makary would update the book. Transparency in medicine is important, otherwise, as Dr. Makary says, we end up choosing doctors and..." Read more

"...solutions offered are enlightening and provide a glimpse of hope for transparency in medicine and hospitals...." Read more

"Martin Makary has done the public a great service by exposing and explaining the ins and outs of the medical profession in his book, "Unaccountable"...." Read more

"...The author also makes the case that with better and more transparent care, costs will come down as an unexpected by-product!" Read more

7 customers mention "Look"7 positive0 negative

Customers find the book provides an important and insightful look into the American medical system. They find it thought-provoking and eye-opening, providing a rare glimpse behind the code of Omerta and the arrogance of power and big business.

"...Unaccountable" is a raw and stark look inside the American medical system...." Read more

"A rare look behind the code of Omerta and the arrogance of position and power and big business...." Read more

"...This was truly eye opening. It was scary on one level and reassuring that Martin Makary was willing to share this insight on the other...." Read more

"A close look at the amount of hidden information about health care, including infection rates, outcomes, competence, and pricing...." Read more

16 customers mention "Story quality"7 positive9 negative

Customers have different views on the story quality. Some find it engaging with a good mix of story and cited authority. They say it's an eye-opening tale of what really happens with medical care. However, others feel the story is repetitive, boring, and jumps to conclusions.

"I have no doubts that it is the most frightening book I had ever read...." Read more

"Excellent book. It is clearly written, a true adventure story, and filled with critical information...." Read more

"...Go to another town if you have to. This was frightening and informative. Not an easy read." Read more

"Enjoyable to read with a good mix of story and cited authority. Every consumer should read and then use it to advocate for change" Read more

29 customers mention "Accountability"0 positive29 negative

Customers find the book's account of the healthcare system unsatisfying. They say it exposes the dysfunctional and corrupt system, with inadequate advice for readers. The content is described as upsetting and scary.

"This book really explains how unaccountable the medical profession is today, and why that's a problem...." Read more

"...The problem is that the health care industry hides and protects bad doctors, bad practices and bad outcomes...." Read more

"...the essence of a kind of malpractice that rarely gets exposed...the disregard, jumping to conclusions, as well as mistakes that occur in small ways..." Read more

"The U.S. healthcare system is in a shambles and this book brings much of the problem into the light...." Read more

Top reviews from the United States

  • Nancy Morse
    5.0 out of 5 stars much needed information
    Reviewed in the United States on October 22, 2012
    Verified Purchase
    This is John's wife Nancy Morse. He is reading the book aloud to me as this way we both "get it".

    Wow. This needs to be made public to everyone.

    We had a child (eventually) die because of meical mistakes and pharmaceutical duplicity, we suspect.
    We are not the kind of people to scream lawsuit, but we have experienced arrogance and undeserved rudeness from the medical profession.

    We are wise now but we know someone who just had five incisions made for a robotic treatment to do a total hysterectomy, repair of the urethra (straightening),a bladder securing and a mesh to hold it in place.
    She remarked that each incision was extremely bruised all around it.And that she was practically placed on her head for this long operation. I would think that all the blood would rush to your brain and this could not possibly be a favorable circumstance.

    My husband says I must not tell her about all of what the author wrote as it is past. She is done with the surgery.

    We live in the Midwest. This surgery was done in a Fort Wayne hospital. We are horrified at the rewards from the companies making these machines and the risk, if the anaesthesiologist cannot access the patient because of the equipment getting in the way. This is appalling.

    We have friends who are nurses. They acknowledge the dreadful state of things in hospitals, the tempers of the doctors, the alcoholics who operate, and on and on, their disregard for "gowning up" that is required by all of the other staff and visitors in the critically ill patient areas. The doctors all walk from one room to another in their ties and suits, with no washing of their hands, handling the charts, the doors, etc.

    It is wonderful that the author has the courage to write and publish this information and it ought to be given as a gift by all of us to those we care about. It is hard to stomach all of this, but his documentation is faultless.

    A puzzle. He is an expert in pancreatic cancer and states that not ever does anyone survive once diagnosed at an advanced stage. We have two friends...one is alive fifteen years later, the other two years now. My suspicion is that neither one ever had it.....and no one admitted it...or it was someone else's test results....who knows. The terror that this produces in the victim, who apparently never had pancreatic cancer in the first place is appalling.

    In one case, in Fort Wayne, a team of cancer specialists told "Susan" that she was at Stage IV and to go home and get her affairs in order. She and her husband, instead, went to Indianapolis, Indiana's IU Medical center, where the doctor told them that she needed to have her gall bladder out. Do you do this to a mortally ill person? They did, and she just passed another "all clear" test. I wonder what she really had.....????

    Thank you for making this wonderful (if hard to listen to) book available and thank the writer especially.
    Nancy (and John) Morse
    7 people found this helpful
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  • Piaw Na
    5.0 out of 5 stars It has the potential to save you and your loved ones a lot of pain.
    Reviewed in the United States on October 6, 2014
    Verified Purchase
    Unaccountable is Dr. Marty Makary's book about the lack of transparency in medicine. For me, it's an eye opener about how to approach healthcare, surgeon selection, hospital selection, and potential surgery. Here are a few (by no means exhaustive) interesting titbits from the book:

    The best hospitals don't pay doctors based on the number of procedures they do, but rather a salary. The incentive based/market based approach breaks down for healthcare because insurance companies pay per procedure, rather than on the basis of patient outcome. As a result of the "Eat What You Kill" model of compensation, many patients get unnecessary and potentially life-threatening procedures rather than minimally invasive surgery.
    If you're told you need major surgery by an older doctor, get a second opinion from a younger one. The younger surgeon might know about newly invented minimally invasive surgery techniques that the older one does not.
    If you're told you need surgery on a major body part for a disease, get second opinions from both experts on the disease as well as experts on the body part. For instance, if you have cancer of the liver, you want an expert on the liver, as well as an expert on cancer of the liver. For instance, many transplant experts would recommend a transplant, while a cancer surgeon would suggest eliminating the tumor through surgery.
    The easiest measure of safety culture is simple. Collect answers from the nurses and doctors of a hospital to the question: "Would you want to be treated at this hospital." This data is actually collected, but isn't published by the government or hospital. Similarly, readmit rates are collected but are not published. This means that it's nearly impossible for a patient to select hospitals on the basis of competency, which is why hospitals compete on the basis of parking lots and advertising.
    Ask for a video of your procedure if possible. Merely knowing that someone else will watch the video improves quality and increases time spent on the procedure.
    Children's hospitals frequently have a more people in fundraising than doctors. That's because fundraising for children's hospitals is so effective that it's a better revenue model than actually treating patients.
    Fundamentally, there's a culture of secrecy in healthcare today where transparency is not the norm. Nearly everyone at a given hospital, for instance, knows which doctors routinely screws up on his patients or has a higher complication rate. But the culture is such that you'll have a hard time getting anyone to tell you this. For instance, a story told in this book was that a patient asked an intern if his surgeon was good. Since his surgeon was terrible, the intern replied, "He's one of the top 4 surgeons in this specialty at this hospital." (There were only 4 surgeons in that department)

    What strikes me over and over again is the importance of culture at hospitals. Makary refers to many prestigious hospitals that nevertheless have poor safety culture (and therefore poor patient outcomes). In keeping with the culture of secrecy in medicine, however, he's not allowed to name them. If you read between the lines, however, you get a good idea of which hospitals he's not recommending. Furthermore, he explains why certain hospitals such as the Mayo clinic are so highly regarded and how they come about having a great safety culture.

    At $3.99 at the Kindle store, buy this book and read it. It has the potential to save you and your loved ones a lot of pain. Highly recommended.
    12 people found this helpful
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  • Amazon Customer
    4.0 out of 5 stars There is no profession where everyone is perfect, or trying to be
    Reviewed in the United States on November 28, 2015
    Verified Purchase
    Frightening and very real. For one who works in the medical field, unfortunately I have to admit that most of what Martin Makary writes here is totally true. The problem is, however, much more complicated than what he presents. If I asked nurses if they knew a nurse who shouldn't be in the field, or teachers, or nursing assistants, or lawyers, I'm sure the answer would be the same. There is no profession where everyone is perfect, or trying to be. And so it is true that there are unscrupulous doctors practicing medicine. It is also true that there is very little control of them - they do not have a "head nurse" to answer to, as we do in nursing. But I personally believe that many of our problems in the medical field stem from the fact that most of us are massively overworked, so that errors occur as a result of this. If less money were spent on fat executives, which he mentions in his book, and more went to employ more staff to actually care for the patients, things might look better!
    Whatever...a good book, which I would reccomend.
    8 people found this helpful
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Top reviews from other countries

  • Thor
    5.0 out of 5 stars The dangers in what you don't know about hospital care
    Reviewed in Canada on July 16, 2019
    Verified Purchase
    This book highlighted the extreme dangers we all face from hospitals which operate with zero transparency and accountability. Even a psychopath has some element of conscience, but not those working in and running hospitals. Learn about the language used to avoid the truth - no mistakes, only near misses - HA! No errors, only adverse events - HA! What you don't know about what is being done to you or your loved one may kill you and good luck, as this book points out - trying to get information about what goes on and what happens when things go wrong. Medical practice and hospital care operates with so much cover-up and legal protection, it is like a licence to kill. learn how to demand accountability and why you need it. Great read!
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  • Cliente Amazon
    4.0 out of 5 stars Very interesting and easy to read
    Reviewed in Brazil on September 7, 2016
    Verified Purchase
    As an investor in health companies in Brazil this book opened my eyes to many possobilities for health system improvements.
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  • Mr M. Pidd
    5.0 out of 5 stars A depressing accouny of healthcare safety in the USA
    Reviewed in the United Kingdom on August 26, 2013
    Verified Purchase
    A depressing accouny of healthcare safety in the USA written by someone deepply within the system who has much to say about how to put things right. The UK may not be the US, but his arguement has merit for the UK too.
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  • Renaissance Reader
    5.0 out of 5 stars Excellent book that hits the point.
    Reviewed in Canada on December 28, 2014
    Verified Purchase
    This book clearly addresses the issues of quality of care and outcomes in a clear and compelling manner. It not only diagnoses the problem but also presents some solutions. It is a must read.
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  • avidreader
    5.0 out of 5 stars brilliant.
    Reviewed in the United Kingdom on February 10, 2014
    Verified Purchase
    I wish people in the UK wrote as much about the NHS - what are we doing for transparency? This is a wake up call. And well written.
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