Here's are some excerpts from the review:
Though concepts such as “accountability” and “transparency” have been trotted out from time to time, Makary believes that medicine is still a closed shop. In Unaccountable, he specifically targets hospitals, arguing that they need to gather, analyze, and publish information vital to prospective patients. They should keep precise tabs on patients’ surgical outcomes, the rate of hospital-borne infections, and other measures, and then put the statistics out where the public can see them (including on the Internet). Doing that would encourage hospitals to hold themselves to higher standards. They would be forced to rehabilitate, train, or weed out physicians and other professionals who need to do better, Makary says, and the practice of medicine would be greatly improved. By focusing only on best practices, hospitals would also reduce the cost of care.
Meanwhile, hospitals see little gain in presenting statistics about their performance, Makary says—another impediment to better treatment. “Their thinking is, ‘What if we have a bad year?’ They’d rather keep the steady stream of money coming in. They know that people view them as a beneficent entity, almost a charity.
While many hospitals highlight glitzy new cancer centers, Makary believes they should emphasize safety at least as assiduously. “Advances in patient safety will save more lives than chemotherapy this year,” he says.
For all the brewing hubbub, Makary insists he’s not so much a single-minded activist as a messenger. “I didn’t create this movement,” he says. “We’re at a turning point in American medicine now. There is a new generation of physicians that believes medicine should be transparent, that is tired of the old b.s., and wants to change things.” But the old guard isn’t far behind—which gives Makary even more hope. The Institute of Medicine, a vaunted research entity that often investigates best practices, and the American Board of Internal Medicine are starting to take accountability seriously. Even the doctor-protective American Medical Association has taken notice. “Doctors are monitoring exactly what they do. They’re researching and questioning it,” he says. “It’s unprecedented.”