INTERNAL BLEEDING: The Truth Behind America's Terrifying Medical Mistakes

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. (Feb.)