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Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care Hardcover – September 18, 2012

4.7 out of 5 stars 257 customer reviews

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Editorial Reviews


“A startling revelation of the dysfunction deeply embedded in the very culture of American medical practice, problems that health care reform scarcely begins to address.” ―Peter Boyer, senior correspondent for Newsweek

“A searing indictment from the inside, arguing that the modern health-care industry, unlike almost every other, doesn't disclose its performance or pricing practices to the public and keeps under wraps information about mistakes and substandard quality.” ―Laura Landro, The Wall Street Journal

“Makary's diagnosis is dangerous, damaging secrecy; his therapy is radical transparency…. [Makary's] argument is powerful…. [he] makes a strong case that the system we have is a disaster for patients.” ―Trine Tsouderos, Chicago Tribune Printers Row

“A very readable, thought-provoking book that will be of interest to health-care consumers, providers, and legislators. The problems pointed out and the solutions suggested deserve to be part of a national discussion.” ―Richard Maxwell, Porter Adventist Hospital Library, Denver, Library Journal

“Makary's book makes it perfectly clear that data transparency not only allows people to make informed decisions about their health but also nudges hospitals and physicians to be more vigilant and efficient.” ―Tony Miksanek, Booklist

“You will be a wiser health consumer for reading this book.” ―Michael E Johns, M.D., Chancellor, Emory University

“This thought-provoking guide from a leader in the field is a must-read for M.D.s, and an eye-opener for the rest of us.” ―Publishers Weekly

Unaccountable is a gripping story about what's wrong with the American healthcare system and what we might do to make it better.” ―Peter Pronovost MD, PhD, Executive Vice-President, Johns Hopkins Hospital

“Every once in a while a book comes along that rocks the foundations of an established order that's seriously in need of being shaken. The modern American hospital is that establishment and Unaccountable is that book.” ―Shannon Brownlee, author of Overtreated

“A galvanizing book full of shocking truths about the current state of health care.” ―Kirkus Reviews

About the Author

Marty Makary, M.D., M.P.H. is a surgeon at Johns Hopkins Hospital and a professor of Health Policy at the Johns Hopkins School of Public Health. He is a regular medical commentator for CNN and FOX News, and appears weekly on a wide variety of programs to discuss health topics. He is a leading patient-safety researcher and led the World Health Organization effort to develop ways to measure healthcare quality. He tweets @DrMartyMD.


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Product Details

  • Hardcover: 256 pages
  • Publisher: Bloomsbury Press; 1 edition (September 18, 2012)
  • Language: English
  • ISBN-10: 1608198367
  • ISBN-13: 978-1608198368
  • Product Dimensions: 6.4 x 0.9 x 9.6 inches
  • Shipping Weight: 11.8 ounces
  • Average Customer Review: 4.7 out of 5 stars  See all reviews (257 customer reviews)
  • Amazon Best Sellers Rank: #266,606 in Books (See Top 100 in Books)

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Customer Reviews

Top Customer Reviews

Format: Kindle Edition Verified Purchase
In 'Unaccountable' Dr. Makary discusses how common sense solutions can fix the healthcare system by empowering patients with information to choose where to go for their medical care. The problem is that the health care industry hides and protects bad doctors, bad practices and bad outcomes.

If the public only knew what really goes on, you would be shocked. In my line of work, I am privy to settlements between hospitals and patients who have been harmed. One common element in all these settlements is confidentiality. Nobody can say anything about the lawsuit, the amount of the settlement or anything. How does the withholding of that information help the public? It doesn't.

The transparency that Dr. Makary talks about is what is needed. But changing the way medicine is done in the USA won't happen overnight. I highly recommend that everyone read 'Unaccountable' and if you find this of interest another book along the same lines called 'Getting Over Going Under: 5 Things you Must Know before Anesthesia' by Dr. Barry Friedberg which covers his 20+ year struggle to change just one item in health care, i.e. getting hospitals to use a brain monitor during surgery.

Hats off to both doctors for shedding light on the health care industry's culturally ingrained obfuscation of the truth and resistance to change.
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Format: Hardcover Verified Purchase
My question, after reading "Unaccountable," wasn't why Dr. Makary had written such a book, but why another doctor hadn't written this book sooner?

"Unaccountable" is a raw and stark look inside the American medical system. Sucking you in, right from the start, with the true story of HODAD - a renowned surgeon at Harvard - worshiped by his patients, but known to all the residents to be the most dangerous doctor on staff - Dr Makary paints a picture of a medical system that is viewed to be a well-oiled machine, but in actuality, is more like "The Wild West," rampant in medical mistakes and impaired physicians.

Dr. Makary argues that transparency is the key to revolutionizing health care in the U.S., and is, instead, convinced doctors and hospital administrators need to stop their ever-present culture of secrecy. Patients should not walk blindly into hospitals, but have full access to a wealth of data regarding infection rates and surgical complications. According to Dr. Makary, hospitals have little to no incentive to improve these "danger zones," to the detriment of their patients, and only once they are forced to be competitive in their level of patient safety will Americans receive the care they deserve.

Though, a bit disappointed that Dr. Makary did not delve a bit more into the unethical mistakes of the pharmaceutical industry, (perhaps he will take on this issue in his next book) he does horrifyingly discuss how cancer doctors actually make a good deal more money if a patient is prescribed chemo than if he is given an alternative option.

"Unaccountable" is not just for doctors, though, it is imperative they devour every word. Above all, it is a necessary read for everyone who has ever known someone in a hospital, has ever been in a hospital or might someday find themselves a patient in a hospital. I'm fairly certain that doesn't leave anyone out!
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Format: Hardcover
As a healthcare provider for thirty years and working in different hospitals as a CCRN, several specialty areas of the hospital, and a pharmacy within the hospital setting, I totally agree with Dr. Marty Makary and wish this book was published a long time ago. However, the facts and presentation he delivers in reference to Doctors and Hospitals being unaccountable, increasing error rates and cost rates, and how to repair a broken healthcare system is valuable information needed to bring to the attention of the general public Now! This powerful, informative, and concise story reveals the shocking truths in a dysfunctional American Medical Practice. This thought-provoking story is essential for exposure of the dangers encountered, so that positive change can reform and repair a broken system. As important as it is to reward Good Performance, it's even More important to frequently check for systemic flaws to ensure that the same mistakes are not repeated. In addition, as the author conveyed the importance of patients being educated through patient-teaching is a crucial factor noted that every patient needs to know what the healthcare workers know. There must be room for improvement, so that the problems could be fixed with mandatory solutions. Frequent checklists need to circulate on every hospital unit and evaluated on a timely basis. This gripping story is a wake-up call for America's current Healthcare system, which is in dire need for repair. I highly recommend this important book to all healthcare workers, and patients. Educational, well-written, and easy to read!
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Format: Hardcover
I have read all the other reviews and I agree with everything they say.

Unaccountable does an incredible job delving into the disturbing world of medicine and unaccountability in our healthcare system. And, don't get me wrong, I, too, was fascinated by the stories of medical mistakes and how those who experience them are `gagged' - meaning, they sign an agreement that, in order to receive their settlement, they will never speak of what happened to them (thus protecting the skin of those negligent and eliminating any chance for change).

But, those terrible stories are not the most important thing I took away from this book - and I think if you walk away from this book filled with fear (or perhaps, stay away from it because of it), you are missing the whole point!

Unaccountable is a book of hope! It has invaluable tools inside that can empower the patient and their families in times of crises when it seems like there are no answers. Having lived through a few horrible medical experiences with ones I've loved, the moment your family member or friend is brought into the ER is NOT the time to begin wondering what to say and ask and "where do we go from here?"
We need to have this information in advance and Unaccountable is like a God-given handbook on how to navigate an incredibly confusing and non-patient-friendly system.

The first thing we each need to do? Take Dr. Makary's list (on page 64) of questions you should ask before any procedure - and then we need to type it up on a little card, laminate it, stick it in our wallet and give a copy to everyone we love for Christmas! You never know when you will need that list! Will you have the book with you when you do? No!
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