Imagine an epidemic that kills over one hundred Americans every day. Now stop imagining.
Each year doctors and nurses kill nearly one hundred thousand Americans. By mistake. They operate on the wrong patients, prescribe the wrong drugs, and leave instruments inside body cavities after surgery. Meanwhile, hospitals spend billions on new gadgets, marble lobbies, and slick billboards even as safety continues to be ignored.
Until now.
Internal Bleeding exposes the dark secrets behind the glistening facade of modern medicine. Doctors Robert Wachter and Kaveh Shojania, professors at one of America's leading medical schools and two of the world's foremost authorities on medical mistakes, shatter the silence to tell the dramatic and compelling stories of real patients betrayed by a system they trusted to save them.
Through these stories, the authors reveal the inner workings, gut-wrenching dilemmas, and heartbreaking tragedies of our overburdened, understaffed health care system. Internal Bleeding provides an insider's view of how professional caregivers think, feel, and operate-facts that every patient and family must know to avoid becoming just another "mistake."
In the groundbreaking tradition of Fast Food Nation, Internal Bleeding paints a vivid and unforgettable picture of a system gone terribly wrong, and what doctors, nurses, hospital CEOs, and policy makers must do to make it right.
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Robert M. Wachter, MD, professor of medicine at the University of California, San Francisco (UCSF), is Chief of the Medical Service at UCSF Medical Center (one of U.S. News & World Report's "Top 10 Hospitals in America") and founding chair of UCSF's Patient Safety Committee. He was the first elected president of the Society of Hospital Medicine, and has published over 100 scholarly articles on topics ranging from patient safety to the organization of hospital care. He is lead editor of the two major academic series on medical errors in the U.S. (Quality Grand Rounds and AHRQ WebM&M), and also edits the popular textbook Hospital Medicine.
Kaveh G. Shojania, MD, assistant professor of medicine at UCSF, is a clinician, teacher, and researcher whose focus is on improving hospital quality and patient safety. He was lead editor of the influential federal report Making Healthcare Safer: A Critical Analysis of Patient Safety Practices, and is associate editor of Quality Grand Rounds and AHRQ WebM&M. He received the 2002 Young Investigator Award of the Society of Hospital Medicine.
"Internal Bleeding is utterly compelling. Dramatic and unflinching, it gives us both the stories of what really happens when things go wrong in medicine and the research that explains what needs to be done. The writing is clear. The ideas are startling. And the tale is important. Wachter and Shojania have written a book that matters." -Atul Gawande, bestselling author of Complications
"Internal Bleeding is ER meets Fast Food Nation. By pulling back the curtain to show us the hidden world of doctors and nurses, it paints a remarkable and unforgettable picture of how medical mistakes happen, and what must be done to cure this modern epidemic. It is a fascinating and essential read for both patients and medical professionals." --David Kessler, M.D., J.D., Commissioner of the United States Food and Drug Administration, 1990-1997.
"The authors have achieved something quite special. The lay reader will journey inside the complex world of medical care today and gain an understanding of the strengths, weaknesses and humanity behind the headlines about medical errors. For any healthcare professional laboring every day to make what they do for patients better and safer, this book is invaluable. It is full of insights, learning and guidance that will help them create and keep the 'culture of safety' that hospitals must achieve for patients in spite of shrinking resources and increasingly complex technology. Read this book." --Dick Davidson, President, American Hospital Association
"Health care could be far, far safer than it is today, but not without widespread public understanding of the nature and extent of its risks. Which brings us to Internal Bleeding-a disciplined, vivid, responsible, and appropriately disturbing exploration of the problems, and the possibilities, in patient safety. Read it, and then demand-and expect-a safer health care system. " --Don Berwick, M.D., President, Institute for Healthcare Improvement
When the venerable Institute of Medicine (IOM) published a report in 1999 citing nearly 100,000 deaths annually as a result of medical errors, it was, Wachter and Shojania contend, news only to those outside the medical field; indeed, it shocked only those outside the medical community. Moreover, many practitioners and hospital administrators might not have been astonished had the figure reported been higher. Regardless, and even though doctors and hospitals had been trying to deal with preventing medical mishaps for years, the IOM's public revelation put them on the spot. The immediate solution: hunt down the culprits and sue them! But resorting to the adversarial system subverts a real solution, say Wachter and Shojania, who in this compendious volume recount some medical horror stories, expose the systemic obstacles that support errors, and propose methods to fix the health-care system. Valuable for the lay patient not just for its glimpses behind the curtain but for its appendixes concerned with avoiding becoming a victim of medical mistakes. Donna Chavez
Copyright © American Library Association. All rights reserved
Although the title of this dense book is more than a little alarmist, Wachter and Shojania, professors of medicine at the University of California, San Francisco, convincingly argue that a flawed hospital system, rather than flawed individuals, is responsible for the thousands of deaths that result from medical mistakes each year. Many of the chapters begin with terrifying but now familiar stories of patients who received fatal overdoses of chemotherapy drugs or had the wrong leg removed in surgery. The authors explain that because of the fragmentation of care in modern medicine, errors are often due to communication problems that arise during patient "handoffs." They also point out that medicine lacks the kind of safeguards used in other high-tech industries like the commercial airline business. While acknowledging the many challenges underfunded hospitals face, Wachter and Shojania offer practical solutions, such as using computers to prescribe drugs instead of relying on often-illegible handwritten notes and employing "hospitalists," who are doctors who focus on integrating care between departments and the inpatient and outpatient settings. As a result, their book should satisfy both those seeking gory details about the patient who left the operating table with a sponge in her body and those looking for a thoughtful analysis of this serious public health problem.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
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