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N**E
much needed information
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
P**A
It has the potential to save you and your loved ones a lot of pain.
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.
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