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HL20: Martin Makary, MD—Pushing to Improve Transparency and Quality Standards

Cheryl Clark, for HealthLeaders Media, November 22, 2013

The checklist took off, was adopted by the World Health Organization, and was lauded in a book, The Checklist Manifesto by Atul Gawande, MD.

"That's the one achievement I'm most pleased with," Makary says.

One area Makary plans to work on is the improvements in the nation's traditional peer review systems, "in ways that remove the politics of the local referral practice system," so poor performers are identified and dealt with.

For example, he says, "having one chest surgeon at your hospital, and having them present morbidity and mortality that they review themselves, alone, or by their brand new junior partner, or a referring pulmonologist—you can not really have regular, fair, standardized peer review when it's knit so tightly in local referral patterns. Medicine is a referral business, especially the high-ticket items like surgery."

Expanding healthcare systems and networks can provide what Makary calls "a tremendous opportunity for hospitals to draw on a broader group of physicians to weigh in on peer review."

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