By Marty Makary M.D.
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Extra info for Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care
Across any industry, business black belts agree that the way to fix a problem is to measure it first, and the results of these surveys can be amazingly informative. S. hospitals now use the survey, all do so under the condition that the results remain top secret, used only for internal viewing by the government and hospital administrators at the participating centers. When hospitals make decisions to not staff their intensive care units (ICUs) with an ICU doctor on nights and weekends, that is a “danger zone” that the safety survey readily detects.
Who wouldn’t want to know where to go for their care? The idea that good data exists but isn’t viewable by the public is outrageous to many Americans—many doctors and nurses included. For the first time in history, Americans are demanding to have comprehensible ways to view medical quality. People are angry with being ping-ponged from doctor to doctor and from test to procedure, not knowing how to discern whether their care is of good quality. A new generation of doctors is also increasingly eager to level with them.
Frederick, a respected colorectal surgeon, on an identical colonoscopy procedure. Just as with Dr. Cotman, this surgeon discovered a golf-ball-sized polyp. It looked so similar, it was almost as if it were the same patient. I asked the surgeon if he was going to remove it using the slick wire-snare technique. He replied, “I like to remove these in the operating room by taking out the colon,” referring to a separately scheduled open operation to remove half of the colon through a large abdominal incision.