Economics In Marty Makary's Unaccountable

The focus area I have chosen for the book Unaccountable, by Marty Makary, is advocacy in economics. It is important for nurses to be aware of healthcare economics, especially since we are the ones at the bedside informing patients, answering their questions, and advocating for their rights. As the American Nurses Association (ANA) states in Provision 3 of their Code of Ethics, nurses must be aware of and act appropriately in all instances of “incompetent, unethical, illegal or impaired practice,” or any actions that place the best interests or rights of the patient in jeopardy (ANA, 2015). I chose to focus on economics because the costs of healthcare constitute one sixth of our economy and is increasingly becoming a burden on families, businesses and government budgets to the extent that it is the leading cause of the nation’s growing debt (Makary, 2012). An
The physicians are compensated for each procedure that they do, regardless of whether it is necessary or beneficial, so they want to do more procedures to make more money (Weisberg, 2012). The other driving factors of delivery of care include commission on certain drugs, such as chemotherapy. Makary explained that most chemotherapy medications are only sold at hospitals, so the doctor and the hospital make “thousands more in income” if a patient chooses that drug. This is incentive for the hospital and the doctor to push the drug on patients who may have other options. Lastly, some doctors are given incentives if they increase their number of procedures. The book gave one example of a surgeon who was told by his department head to try and do more operations, as his “productivity” would be used to determine his bonus (Makary, 2012). All of these factors switch the focus of delivery of care away from safe and good quality care for patients to whatever will increase