5 Surprising Confessions of a Surgeon

Nov. 30, 2012— -- intro: Dr. Marty Makary is one of the leading surgeons at Johns Hopkins Hospital in Baltimore and the author of "Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care," in which he pulls back the operating-room curtain to air what he claims are hospitals' dirty secrets.

Have you ever been operated on by a Dr. Hodad? If the name doesn't ring a bell, that doesn't mean you haven't. Click through to learn more and read Dr. Makary's revelations.

quicklist: 1 title: A Third of Surgeries Aren't Neededtext: Surgery is big business, Makary said, and few who've seen the bill after an operation would disagree.

Almost a third of the time, it's also unnecessary, he claimed.

"By and large, many doctors are still paid on what we call in the industry an 'eat what you kill' model," Makary said. "If you do an operation, you will go home with a thousand or two thousand dollars more than if you didn't do the operation."

"The incentives are huge," he continued. "If you look at pap smears, back surgery, heart stents -- there is a lot out there that we are doing that we shouldn't be doing."

Watch the full story, plus other shocking confessions, on "20/20: Confessions" Friday at 10 ET.

quicklist: 2title: Beware of Doctor Hodadtext: Makary said bad doctors are more common than you think.

"Every hospital has a doctor that was locally referred to as Hodad [in] the places that I rotated through," Makary said.

Hodad?

"Hands of death and destruction."

What's even scarier, Makary said, is nobody ever tells Dr. Hodad's patients. In one case he saw, the patients were easily seduced by Dr. Hodad's bedside manner.

"Patients requested him," Makary said. "Celebrities, CEOs, famous people would fly in from around the world just to have him operate on them.

quicklist: 3 title: Operating Under the Influencetext: "Health care is a funny field; you can have a DUI and walk right into the operating room the next morning. The [Federal Aviation Administration] would never allow that, because there are national guidelines for pilots ... arguing that it's part of public safety," Makary said.

So it's not part of public safety to prevent having a woefully hung-over surgeon operate on you?

"These are the problems that happen when you have people who are in over their head and the oversight is very poor," Makary said.

Take Dr. Kristin Howard, a recent "Doctor of the Year" at Newton Wellesley Hospital, in Massachusetts. Authorities said she was caught on tape this month tearing out of a supermarket parking lot, under the influence of alcohol and pills she had prescribed herself.

When she was stopped by police, she was wearing scrubs, and she reportedly told them she was on her way to the hospital. Howard has pleaded not guilty to driving under the influence and drug charges.

"If the rate of substance abuse in America is around seven to 10 percent, why do we think it's lower for doctors?" Makary said.

quicklist: 4title: Doctors With Baggagetext: Doctors who make medical mistakes often go on to inflict pain and suffering again, Makary said. He said the problem was systemic.

"You can lose your license in one state and then just hop over to the other state and not disclose what happened. Many people who lose their license in health care become doctors in an adjacent state," he said.

In his book Makary tells the story of a doctor who was interviewing for a position at his hospital. She impressed everyone in her interviews, but when Makary's hospital emailed her last employer, they shot one word back.

"'Run,'" Makary recalled.

"You just can't really tell much from a sit-down conversation with a doctor," Makary said. "[The applicant] impressed us, and she probably is impressing people who she is treating [somewhere else]."

quicklist: 5title: VIPs Get Worse Caretext: "Most VIPs, most wealthy people in the United States, get the worst medical care," Makary said. "The reason is that doctors will go out of their way to do something special for them. And that's when things go bad."

He told of a foreign VIP who came to Makary's hospital for an operation.

"Instead of going to the pre-operative checklist room where a series of checks are done before going into the operating room ... someone thought it would be good for them to skip it and go right into the operating room. Well, I sent that patient right back out to the pre-operative hold area and said, 'We have got to do our standard check that we do for everybody.'"