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on July 17, 2001
Peter Clement's charismatic hero, Dr. Earl Garnet, outspoken chief of ER services at St. Paul's Hospital in Buffalo, has always been something of a maverick. Deeply caring and utterly involved in his profession, he puts his patients before what's politic and his professional ethics before personal advancement. His infinite capacity for outrage in both areas is tested to the hilt when a baby arrives too late and dies in his ER because the mother's HMO had withheld not timely treatment, but their guarantee to pay for it. He subsequently publicly charges powerful Brama Health Care with "No fault murder" and opens a can of worms that rocks the hospital's hierarchy to its core. Dr. Clement's own years of experience and technical expertise in ER medicine coupled with his brilliant flair for suspenseful plotting and and non-stop action make this latest addition to an already best-selling medical series almost impossible to put down. As has been the case with his two previous thrillers, he keeps several plot-lines running in tandem. Shortly after the baby's death, a doctor who might have been associated with Brama is found brutally murdered in the hospital parking lot, and another doctor, an alcoholic friend and former colleague of Garnet's, disappears after enrolling in a secret, experimental drug rehab program which also appears to be linked to the HMO. As the financial stakes increase and pressures to cover-up and deny mount, Garnet finds himself increasingly alone in his attempts to establish a connection between these apparently disparate events that will provide tangible proof of murder, malfeasance and corruption in both the HMO and the medical establishment, bring the real culprits to justice and create the desperately needed mandate for managed care reform which he sees as a personal imperative. In order to do this, he ultimately puts his own life on the line with utterly spine-tingling results.
I believe that Dr. Clement is a 'muck-raker' in the original and most honorable sense of the term. He wields his creative talent like a scapel with devastating power and accuracy to expose the multiplicity of flaws and shortcomings inherent to our present system of medical care, and it is impossible to come away from his fictional world without having some terrible concerns about the real one which we all have to deal with sooner or later ourselves.
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What would authors of medical thrillers do without HMO's? In dozens of medical thrillers, the administrators of HMO's and the physicians belonging to them either withhold vital care, engage in ghoulish experimentation, or actively kill their patients in order to reap greater profits.
In Peter Clement's "The Procedure," the hero is Earl Garnet, Chief of the Emergency Room in St. Paul's Hospital, located in Buffalo, N. Y. Garnet is enraged at an HMO called Brama, which has engaged in a deliberate campaign to discourage patients from going to the hospital. The officials at Brama let their patients know that if their ailments turn out to be minor, then the patients themselves will be solely responsible for their hospital bills. Unfortunately, a number of patients die because they delay going to the hospital until their conditions became too serious to ignore. Garnet angrily calls Brama's tactics "no-fault murder".
The HMO decides to boycott St. Paul's in order to punish Garnet, and his fellow physicians are annoyed with him. However, all this takes a back seat to a series of brutal murders that occur on the grounds of St. Paul's. Someone is slashing physicians' throats and the police do not have a clue who the murderer is or what his motive may be.
Gradually, Garnet and Riley, a policeman assigned to the case, realize that the murders are somehow tied to the Brama HMO and to a shadowy facility that Brama runs in Mexico to treat hard-core alcoholics. Garnet risks his life to uncover the truth about Brama and to bring the HMO to its knees.
Clement is very good at describing medical procedures. The scenes that take place in the operating room and in the emergency room are authentic and exciting. His indictment of HMO's, while not a new theme in medical thrillers, does hit home.
However, the characters are the same old tired stereotypes. Garnet is the intrepid hero who is unafraid to go into the lion's den to uncover the truth. He has an equally heroic friend named Jack who also is willing to give up his life to defeat the HMO's. The bad guys practically twirl their mustaches as they perform their villainous deeds. The identity of the killer is obvious long before the end of the book, yet the author springs it upon us at the end as if it is a big surprise.
I give "The Procedure" high marks for the author's medical know-how, but low marks for the contrived plot and the stereotyped characters.
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on December 1, 2002
I really enjoyed this book and am glad that there are no HMO's in Quebec. As exciting as the previous ones, couldn't put it down. Dr. Garnett is like a hound following a scent, he never lets up. I anxiously await the next round with Dr. Garnett et al.
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on May 29, 2001
The HMO informs the mother that eighteen-month-old Robert Delany had a cold and did not need ER treatment. When she called back they said use your judgment, but we will not pay for treatment unless a true emergency exists. Still worried, the mother rushes her son to the nearby Buffalo hospital, but it proves too late as the infant dies. The head of ER, Dr. Earl Garret blames the HMO Brama for the death of the child although the managed health provider worked within the law.

Brama Health Care refuses to send patients to the hospital unless Earl is fired. As Earl receives the pariah treatment from peers who seen their wages drop ten percent, someone murders Dr. Sawold in the doctor parking lot. The medical community blames the homicide on Earl stirring up trouble with the unfortunate Delany case. Rather than sit idly by waiting for the police to solve the case, Earl begins making his own inquiries.

THE PROCEDURE is more than just a taut medical thriller. Peter Clement makes clear his position on the current state of health care in the United States, condemning it as an outrage. The hero is a caring person who is punished for wanting to provide the best medical treatment for his patients regardless of the HMO bottom line mentality. Though one-sided, Dr. Clement still provides an exciting amateur sleuth medical thriller that will keep reader attention until the final page.

Harriet Klausner
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on April 13, 2003
I found this book to be extremely long. You read a climatic point at the beginning of the book, which allows you conclude certain things, but are forced to listen to Dr. Garnet try to figure out stuff for 304 pages! It was interesting from then on and I quite enjoyed the ending. So if you would like to read this story, DO NOT READ THE PROLOGUE! I guessed a lot of stuff from it and I am 18 year old lifeguard!!
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on December 25, 2001
Outstanding. High suspense. Very engaging from the first page to the end. Accurate descriptions that really put you in the shoes of the characters. Evokes emotions that draw out outspoken responses throughout the book. Wanted to read the book at red lights in traffic.
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on August 30, 2003
It was authentic, thrilling, with excellent characters, plot and suspence.
Peter and Veronique
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on February 16, 2009
This book had some good parts, there's no arguing that, but getting to all of the interesting parts that add up to the moving line of the story is a difficult process. The Procedure could stand to lose at least 100 pages. Hopefully such a slim down would also help the main character be more consistent. Dr. Garnet shifts between a strong lead and a limp noodle, sometimes in the span of a single page.

The Procedure is the kind of book you leave on an airplane when you're done with it.
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on June 30, 2007
Peter Clement engages the reader in a fast moving and spell binding read about the inside operations of the heath care systems in hospitals. He exposes the control that insurance companies hold over health care and the inordinate amount of money to be made in this business. At the same time he does renew faith in the many healthcare workers who deliver their best in spite of the insurers.
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on August 30, 2008
One star for a good topic, but the writing is stilted, the book should have beeen half the length. I'm sure Dr Clement is a very good physician but the book desperately needed an editor & preferably a professional coauthor. There were passages I skipped becuase they were just unnecessary, unreadable & honestly, the characters are stereotypical. There are far better medical thrillers.
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