Hopkins Surgeon Blasts Healthcare Safety, Ethics

Cheryl Clark, for HealthLeaders Media , September 13, 2012

I imagine that people who read his book will fret that their doctor is among those surgeons prone to perform procedures "as medically unjustified as injecting Botox into a furry dog."

Or that they are laggards who will use more dangerous, more invasive techniques simply because they lack the training to perform minimally invasive, safer procedures, and—out of greed—won't refer patients to a more competent provider who is better trained.

Makary's desire is for patients to be more skeptical and curious, to find out more about their providers, their hospitals, and their doctors.

"As a homeowner, you wouldn't hire a plumber to fix your fuse box," he writes. "The plumber's error could easily cause a spark that could burn your house to the ground. Yet every day there are patients sitting in waiting rooms waiting for the wrong doctor to treat their condition."

Makary, 40, is not your average doctor. He is a frequent contributor on CNN, and once was reportedly under consideration to be President Obama's Surgeon General. And he worked with Johns Hopkins' intensivist Peter Pronovost, MD, to reduce central line bloodstream infections through the well-known "checklist."

In an interview this week, I asked Makary what prompted him to write this horrifying "doctor-tells-all" book, and what he expects to accomplish with it.

The idea came four years ago, he says. That's when laparoscopic removal of the tail of the pancreas to remove cysts or tumors became the standard of care. It is vastly safer and better than the traditional "open" incision operations, he explains.

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5 comments on "Hopkins Surgeon Blasts Healthcare Safety, Ethics"

TTGoodell,RN,PhD (9/20/2012 at 6:56 PM)
I've been an ICU nurse for 30 years. In this time, I've been scolded and even administratively warned for criticizing poor physician practices (and I've seen it happen to others). Docs are still seen, as Makary seems to being saying, as moneymakers and therefore beyond the reach of all criticism. On the other hand, docs are quite free to excoriate nursing practice if they don't like it, right or wrong. This points out the dangerous hierarchy that exists in health care; an outdated model that looks more like 19th century obedience to a master than 21st century collaboration among equals.

Fred Shield, M.D. (9/18/2012 at 3:53 AM)
"In the excoriating book, Unaccountable, Martin A. Makary, MD, portrays a healthcare industry operated by a deceitful and dangerous cabal of over-worked charlatans who frequently profit from unnecessary and unsafe medical procedures." This sounds like a commentary from an arrogant and elitist physician that needs a few more years to mellow and get in touch with reality. How long has he actually practiced, what with all the political and TV time he seems to spend. I invite him to spend two days in my semi-rural hospital and see if he comes away with the same attitude.

Linda Galindo (9/17/2012 at 3:29 PM)
Thank you Dr. Makary. Finally the truth of the matter out there in even plainer terms. I teach the implementation of a mindset of personal accountability in healthcare cultures and its relationship to patient safety and quality care, but the number one comment I get when pulled aside by audience members (usually nurses) is that "the hospital culture will not allow them to hold physicians or even each other accountable!" It's nuts and dangerous and everyone KNOWS that not holding the under performer or uncooperative accountable because they admit the most patients is punishing the best performers. Physicians do not need to get their MBA's to learn to lead in this environment, they have to do the harder thing and introspect and admit their role in the current culture which is "not being accountable gets rewarded MORE than being accountable." It is not "just a few bad apples." Every doc regardless of status who talks ABOUT, but not directly TO, the offenders is complicit. The more they leave it up "to others" to clean up the healthcare culture the more rules, regulations and attempts to control they are inviting. The lower the personal accountability in a population the more victims and need for rules and laws that end up punishing the rest of the support system in place for patients. Thanks again Dr. Makary, it's exactly what's needed. The Straight Truth.




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