Rosenthal discusses the tension many medical professionals feel between prioritizing profit and prioritizing patient care. In a field increasingly ruled by unfettered market interests, every sector of the healthcare industry is forced to consider financial gain on a similar, if not equal, level to patient care. This theme is in play at the very beginning of Chapter 1, when the reader learns that Jeffrey Kivi’s clinic collects royalties from his use of a trial drug. The passages following the story detail the humble beginnings of insurance plans, and how they were meant to support teachers and other workers in doing their jobs. That past and the modern reality conveyed in this book are at complete odds with each other.

Not all physicians are exploitative and money hungry. Some seem to genuinely struggle with their inability to properly balance the expectations of working in the field. Dr. Lakowsky, who struggled after selling his independent practice to medical conglomerate Sutter Health, is an example of a figure who has difficulty balancing the two facets of the healthcare industry. He partially sold to Sutter Health for financial reasons, acknowledging that he would receive 25 to 30% more than he had been making previously.