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A young doctor tries to bring down a villainous HMO.
on October 3, 2001
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.