Marty Makary MDReseñas

A must read for doctors as well as patients

I have mixed feelings about this book. It is supposedly a biography of "Mama" Maggie Gobran, who was nominated for a Nobel Peace Prize for her work with the poor of Egypt.

At her insistence, the book also talks quite a bit about her colleagues working with the nonprofit she began, Stephan's Children. These were the parts I liked best.

There isn't really much here about Gobran's early life, and the authors write about her with stars in their eyes. Most biographies will acknowledge that all humans have strengths and weaknesses, and will explore both relating to their chosen subject. This biography conveniently ignores any mention of Gobran's flaws, and goes on and on about how great she is. Even though Jesus is mentioned, and I believe Gobran would have wanted Him to be exalted, the authors seem to value Gobran more than Him.

There are also a couple instances of Gobran "prophesying," aka predicting the future - this was a huge red flag to me. I believe that Jesus was the last Prophet and that He fulfilled all prophecy, so anyone today with the gift of "prophecy," if you will, really just has a gift to boldly speak the Truth about Jesus and His kingdom - not clairvoyance.

There is also repeated mention of "Christians" who have never actually heard of Jesus. I wish the authors had done a better job of distinguishing actual Christians from nonbelievers, who identify with the title "Christian" culturally, but do not actually follow Jesus Christ.

I do appreciate that the Gospel is spelled out in the pages of this book, but I don't feel like it necessarily qualifies as a "biography."

Side note: The formatting of this book left a ton of fully blank pages. What a waste of paper!

Read.
This.
Book.
Now.

You will thank me at some point... whether it's before you have a c-section, an emergency appendectomy, back surgery in 40 years, etc. Although hopefully, by the end of 40 years, things will have changed.

This gives you information about the way insurance and medicine are mismanaged to your detriment. Ask your friends in healthcare what they honestly think about their job, their clinic, their Drs. and, if they trust you, they will confirm much of this information.*

*One thing I think that he missed was the fact that many employment contract clauses at clinics stipulate that negative speak from employees at the clinic/hospital about physicians and other healthcare professionals can be grounds for dismissal.

This was a good presentation of the problems in the healthcare business model. I appreciated the fact that the author included examples of disruptors of the system which gives hope for the future. Recommend if you are interested in digging into the weeds of medical billing and its impacts on the providers and on the consumers. It is written in a very accessible style. Lots of data, but not wonky. There are some legislative updates which occurred after the first publishing, specifically surprise billing and hospital price transparency. I assume his paperback version published in 2021 includes that information.

This was a frustrating read. The data was good; the analysis and conclusions, not so much.

The good parts: The data and stories about how much we pay, the inaccessible chargemasters, the opaque billing, CEOs who don't know their ass from their elbow and claim ignorance of how their hospitals operate. Dr. Makary does a great job of showing many of the ways in which the system fails.

The bad: Trying to analyze the situation and draw political conclusions. Makary is a fan of price transparency. I'm not opposed to that, per se, but he doesn't address the myriad limitations to the problem. Once your care costs enough, it is immaterial to you whether it's $30K or $50K; you've hit your maximum. Second, you don't always have the ability to do research, either because it's urgent or because the patient is generally incapable. The issue of pushing the burden onto patients isn't really addressed. Third, lack of competition. One of the highlighted stories is in Carlsbad, NM, where the local hospital has a record of suing for unpaid bills. The next nearest hospital is in Roswell, an hour away. That's usable for some people some of the time, but for other people and times, Carlsbad's hospital has a captive market. With increased consolidation in healthcare, transparency will be only so useful as a tool.

He's also a little overly generous about the motivations of doctors and administrators, which is interesting considering his opening story about predatory surgeons promoting unnecessary surgery. Doctors respond to incentives, both good and bad.

To his credit one segment is about improvement at the hospital level, by using data to improve surgical outcomes. However, in some cases he's prone to tossing off anecdotes. For example, that providing price data for deliveries meant "everyone" selected the cheaper hospital, with "no loss of quality." It's worth noting that the example was in Boston, where Partners Healthcare has been accused of driving costs up at the most prestigious hospitals. I know from personal and friends' experience that even when price data is available, that the more expensive option may be chosen because of real or perceived differences in quality or other factors. (For example, I chose to deliver in a more distant hospital because I preferred its maternal-fetal medicine team, and would have done so even if it had cost more.)

He also talks up companies self-insuring and the use of health shares without mentioning downsides (self insured companies are exempt from the requirements of the Affordable Care Act; health shares do not guarantee payment).

It's a shame because the basic data gathered is really interesting; he just doesn't know where to go with it.

Sometimes you hurry through a book because your TBR pile is the size of K2. I read this within one day. But towards the end, I began to realize how wonderful this book is, it is certainly as good as the effort of his contemporary Dr. Gawande. They apparently collaborated on checklists. Robots, business pressures, lack of critiques and accountability, lagging performance behind the aviation sector, etc. are all handled in a very readable manner. It's not a new book anymore, but it's a good one.

This book told the inspirational and fascinating story of the work of Mama Maggie, described by some as Egypt’s version of Mother Teresa. It must be said, that I am no fan of the latter, but I do think that the work of this Egyptian Lady and his ministry is comparable with those of some of the great Christian Charitable founders of the past, like William Booth and Dr Barnardo.

The devotion and self-sacrifice of Maggie and many of her co-workers, who chose to forego lucrative careers, or give of themselves and their time to help the people who dwell in Egypt’s slums is challenging and touching. I found myself highlighting a number of passages, highlighting the emptiness of chasing riches and success, and being distracted by worldly concerns.

I did have a few concerns about some passages, which seemed to suggest that Stephen’s Children does not attempt to convert or preach the Gospel to non-Christians, focusing on positive thinking, self-worth and telling everyone they are children of God. We are all God’s creation, but the scripture seems to be quite clear its designation that only those who are believers in Christ are God’s children.

It seemed that many Copts, although identified as Christians, had not even heard of Jesus and knew nothing about Christianity. For these, the work of the ministry does seem to be genuinely transforming people’s lives, including those with harrowing stories of abuse and drug addiction, by bringing them to the Lord, and it does seem as though Maggie is a true believer.

Altogether, a worthwhile and truly inspirational read, even if the writing style is not the best. Recommended.
I recieved this book free from Thomas Nelson via Booklookbloggers for review. I was not required to write a positive one and all opinions expressed are my own.

Excellent book. I appreciate the results of Marty's research. It is refreshing for someone to provide an honest and patient centric perspective on the current medical system. I agree that accountability is the key to improvement. I hope that his perspective will be adopted.

The painful reality of what has been historically tolerated in healthcare and a clarion call to transparency as one of the solutions

A profoundly disturbing "inside look" at America's health care system, but also a hopeful call for more transparency, accountability, and patient-oriented treatment. Much of the book is difficult to read, as Makary recounts horror stories from his career and reveals the dirty little secrets that hospitals don't want you to find out. His suggestions, though, are almost all based on pure common sense and seem as though they'd save a great number of lives.

Recommend by cousin Mildred