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According Marty Makary‘s book Unaccountable, over 30% of medical procedures carried out in the United States are unnecessary. There are over 200,000 deaths from medical mistakes a year. Medical mistakes and preventable infections taken together is the #3 cause of death in the United States.
The problem is a lack of transparency in healthcare. I think the debate about healthcare in this country has been missing the main problem: in order for consumers to make a decision about their health, they need to have INFORMATION about the health services they’re “shopping” for. There is a culture of secrecy among doctors, as a result most consumers choose their doctor almost randomly based on factors that do not directly relate to their essential unmet needs.
Here’s my example of a good system… First, I Google the symptoms I’m having to get some basic information about the underlying conditions that could be causing the symptoms. As an imaginary example, say I suspect that I have an abdominal hernia. I look it up online, and it says that normally this requires a hernia repair surgery that costs an average of $5,000. I would like to be able to go online and find doctors near me that perform this surgery often and have gotten good reviews. Also, I would like to sort those options by price of the surgery. This data is out there! But unfortunately it’s not easily accessible.
Instead, as a consumer, we can’t know if the doctor we went to has done zero, one, or one hundred hernia repair surgeries. We don’t know up front what all the options are and what the price of each option is. What are the benefits, what are the costs?
According to Makary, doctors are pressured to hit quotas in the number of surgeries they perform, and maintain secrecy to avoid exposing themselves to lawsuits. I think doctors should be exempt from lawsuits. The only punishment for a screw-up should be whatever the consumer decides is appropriate when that information is made public.
Makary provides a lot of practical ideas for opening the channels of honest communication. For example, he suggests that all patients be provided with the video of their operation.
Check out a C-SPAN interview with Marty Makary where he preaches the message of openness in the medical profession.