Rating: 
Summary: Engaging storytelling and thoughtful analysis
Review: My wife is a physician and has explained bits and pieces of this field of medical error and patient safety to me, so I decided to pick up the book. Also, as a teacher, I'm always on the look out for potentially interesting books to recommend to motivated students. I'm not sure what personal animus "Typical Wachter" guy has with one of the authors, but I found the book anything but typical. Despite the sensationalistic title, I found the writing to be a nice balance between drama thoughtful explication of the underlying issues. One of the reviewers on the cover jacket described it as ER meets Fast Food Nation, and I think that actually captures the book surprisingly well. Last year I read FFN, and, though I admired the writer immensely for his accomplishment and found the material quite interesting, I have to admit I faded towards the last third. Not so with this book. Many of the chapters are quite self-contained (the way a New Yorker, Harpers, or Atlantic article might be), but I still found myself going from one chapter to the next without losing any steam.. My wife's reading it now, too, and she has also been impressed with the degree to which the material is likely to be interesting to medical audiences (she already plans on recommending it to a few of her colleagues) as well as the general public.
Rating:
Summary: Important reading for patients andhealthcare providers
Review: Nearly every disease or medical condition has a group that works to bring attention to the importance of spending time and money to understand and control it. A key activity for these groups is to bring the disease to the attention of the public in an effort to influence the flow of money and talent to their cause. Some diseases affect such a small number of people that it is impossible to reach a critical mass of affected or interested people to be able to influence politics or market forces. Others may affect a large number of people, but fail to receive the support of the public and those that fund research. In the 1980s AIDS was in this latter category until the a critical mass of activists took up the cause and moved it high on the list of diseases receiving support from federal sources, private industry (pharmaceutical companies), and the public at large. In the last few years it has become it has become clear that medical errors can be thought of as an epidemic (though not a new one) needing the same kind of support that led to significant improvements in the transmission and treatment of AIDS 15 years ago. There have been a number of reports about the problem in the medical and lay press, but it remains a disease that doesn't yet have many energetic and vocal activists. Internal Bleeding may change that. Wachter and Shojania have written an entertaining and easy to read overview of the problem, including the work done by a handful of very talented researchers to understand the root causes and potential solutions. It is full of anecdotes of medical mistakes with a more thoughtful analysis of them than what one can learn from the newspaper or nightly news. The book is likely to engage the public more than previous academic reports and TV news segments. It may move medical mistakes and healthcare quality overall, up on the list of our nation's priorities more successfully than other efforts to date.
Rating: 
Summary: hospitalists are horrible for your care
Review: obviously these two work for a large hospital; one that believes it is better for their doctors to stay at the clinic rather than see their patients at the hospital-if they are admitted. The idea that these two tell us that hospitalists are better for us than our own doctor tells me they have their own agenda. Be careful of what you read.
Rating:
Summary: Wonderful and informative- a must read!
Review: The biggest problem I had reading Internal Bleeding was that I ultimately needed to put it down! It read like a gripping and juicy novel, except that I needed to keep reminding myself that the "characters" in this book were real-life victims of real-life medical mistakes. By coupling anecdotes (many of which were surprisingly funny) and easy-to-understand analogies with remarkable research and graphic case histories, the authors left me shocked, touched, and with a thorough understanding of the epidemic we have on our hands and what needs to happen in order to address it. Andrea LoBue, M.A,
Licensed Marriage and Family Therapist
Co-author of The Don't Diet, Live-It Workbook
Rating:
Summary: Wonderful and informative- a must read!
Review: The biggest problem I had reading Internal Bleeding was that I ultimately needed to put it down! It read like a gripping and juicy novel, except that I needed to keep reminding myself that the "characters" in this book were real-life victims of real-life medical mistakes. By coupling anecdotes (many of which were surprisingly funny) and easy-to-understand analogies with remarkable research and graphic case histories, the authors left me shocked, touched, and with a thorough understanding of the epidemic we have on our hands and what needs to happen in order to address it. Andrea LoBue, M.A,
Licensed Marriage and Family Therapist
Co-author of The Don't Diet, Live-It Workbook
Rating:
Summary: Witty, wise and and trenchent. A wonderful read.
Review: The problem of medical errors in our healthcare system is tremendously important, but other than the occasional sensationalist headline, is normally the purview of health policy experts and their academic literature. And a very dry literature it is. Wachter makes this issue accessible to the layperson and professional alike, and in a way that makes this book read like a suspense thriller. It's hard to put it down. I love the intercutting between actual cases and exposition of the policy issues they highlight. My only objection is that the title is a bit hyperbolic. The problem is real. But with experts like Wachter on the case, there is no need for panic. (Another reviewer, Chris Uhlhorn--doubt his real name--- seems to have had internal bleeding of his own. Perhaps intercerebral? Clearly has an ax to grind... )
Rating:
Summary: Excellent insights
Review: This extremely informative book provides unjaundiced insights into the way errors occur, describes the hierarchy and complexities of medical training, helps to demystify the culture of medicine, and enlightens readers about the organization of hospitals and delivery of medical care in a dramatic and engrossing manner. The authors have a mission, but choose to teach, rather than to proseletyze. There are helpful suggestions for patients, as well as sophisticated and thoughtful analysis for medical professionals.
Rating:
Summary: Interesting, well researched, and well written
Review: This major effort seems to have touched all the bases. It leaves virtually no possible cause of medical errors unexamined. It does, however, seem to employ its excellence in describing gripping case studies as a distraction much of the time, often leading one's attention away from the root causes it seems to prefer not to pursue.
I refer, to cite but 2 examples, to 1.) the touch-and-go treatment of the selection and education of medical students and 2.) to the issue of the cover-ups that are the consequence of the "Brothrhood" of physicians.
Our impressively literate authors manage, disappointingly, to leave issues like these without much examination and to virtually leave considerations concerning them out of their "solutions."
They properly make much of the "culture" of physicians, yet offer no ideas as to how to modify this culture at the med school level, rather than after the wrong people (drug addicts, among others)have been trained and are wreaking havoc. Drug addicts, by the way can be picked up by tests before, during or after med school - as can asocial individuals. Such tests, strangely and destructively, are not employed in the medical culture (as they are in industry.)
Nor do the authors seem to be aware of the possiblity of, or to encourage the employment of, others than physicians and their handmaidens to try to right the problems that are killing hundreds of us daily. They, like most physicians, seem to prefer having foxes guard the henhouse. And, given the culture they describe, this traditionaly hubristic practice (self-policing or peer review) virtually insures that proposed solutions will be destructively doctor friendly and largely leave the patient to his own resources.
The systems oriented approach that they champion, and which the Bush administration and the AMA seem to have picked up on, has the advantage of being relatively easy to implement. Bush and the AMA are, therefore, all for electonic help for doctors, and advanced computers will certainly help, but GIGO (Garbage In-Garbage Out) applies to their computers even as it does to ours. And tired, incompterent, impaired or indiferent staff can readily compromise the efficiency of such aids.
Such solutions also distract from, and ignore, important needs such as those mentioned in the 2 examples noted above - without which meaningful reform of the medical culture simply cannot occur.
And so, I see their "solutions" as mere paliatives awaiting the more difficult structural changes that I and others have thus far only hinted at.
Reading this book is tremendously informtive about a lot of things (and it is entertaining) but don't confuse its contents with anything like a meaningful solution to the problems of American health care. It , emphatically, isn't.
Rating: 
Summary: Brilliant, Inclusive and Wrong!!
Review: This major effort seems to have touched all the bases. It leaves virtually no possible cause of medical errors unexamined. It does, however, seem to employ its excellence in describing gripping case studies as a distraction much of the time, leading one away from root causes it seems to prefer not to pursue. I refer to, to cite but 2 examples, the touch-and-go treatment of selection and education of medical students and the issue of the cover-ups that are the consequence of the "Brothrhood" of physicians. Our impressively literate authors manage to leave issues like them without much examination at all and to virtually leave them out of their "solutions." They properly make much of the "culture" of physicians, yet offer no ideas as to how to modify it at the med school (blunt end) level rather than after the wrong people (drug addicts, among others)have been trained and are wreaking havoc (sharp end.) Drug addicts, by the way can be picked up by tests before during or after med school - as can asocial individuals. Such tests are not employed (as they are in industry - which the authors employ as examples elsewhere.) Nor do they seem to be aware of the possiblity of, or to encourage the employment of, others than physicians and their handmaidens to try to right the problems that are killing hundreds of us each day. And, given the culture they describe, this traditionaly hubristic practice (self-policing) virtually insures that proposed solutions will be top-heavily doctor friendly. Their systems oriented approach, which the Bush administration and the AMA seem to have picked up on, is advantageous in that it is relatively easy to implement. (Bush and the AMA are all for electonic help for doctors) and advanced computers will certainly help but such solutions ignore at least equally important needs such as those mentioned in the 2 examples noted above - without which meaningful reform of medicine will not occur. And so, I see their "solutions" as mere paliatives awaiting the more difficult and realistic changes that I hint at. Reading this book is tremendously informtive (and entertaining) but don't confuse it with a meaningful solution to the problems of American health care. It isn't
Rating: 
Summary: self-serving doctors write book
Review: Why their way is the best way. I suggest you read What your doctor Won't Tell You. This is a gutsy non self-serving and tell all book that will help you get through our terrible health system
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