The surgeon and Johns Hopkins School of Medicine faculty member is well-known for his part in developing the Surgical Checklist, which took inspiration from the checklists pilots use to improve patient safety and outcomes.
In September, he published “Unaccountable” which called for more transparency in medicine. He advocated for measures like allowing patients to see doctor’s notes in real time and routinely videotaping procedures and allowing patients access to the recordings.
The Daily Journal’s Michaela Gibson Morris talked to Makary about how more publicly available health quality information can make health care better and safer.
Q: What should health care providers do?
A: The best place to measure quality is at the hospital level. You can measure re-admission rates, infection rates and never events. (These are well-defined, catastrophic errors like operating on the wrong side of a patient’s body.) It creates an incentive for bad outliers to give doctors and nurses what they need to do their jobs better and safer.
Q: What can patients do?
A: The public is going to insist on more transparency, just as it insisted on more transparency on Wall Street and in the White House. Health care has been exempt, but I don’t think it’s going to stay that way. (Makary recommends patients seek out quality data from reputable sources such as consumerreports.org/health, hospitalcompare.gov and zocdoc.com.) Every year we’re seeing more and more information populating these sites.
Q: What should we do as a nation?
A: I think there’s a limited amount that government can do. But it can give taxpayers better access to information they are already paying to gather. There are 30 national registries (tracking outcomes on diseases, conditions and hospital outcomes.) The public only has access to a couple of them. Those databases represent a treasure trove of quality information and scientific discovery.