Review of: MARC A. RODWIN, MEDICINE, MONEY & MORALS: PHYSICIANS\u27 CONFLICTS OF INTEREST. (Oxford University Press 1993). [430 pp.] Acknowledgements, acronyms, appendices, foreword, index, notes. LC: 92-49488; ISBN: 0-19-508096-3. [Cloth $25.00. 200 Madison Avenue, New York NY 10016.

Simon, Mitchell M.

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RISK: Health, Safety & Environment (1990-2002)Volume 4Number 4 RISK: Issues in Health & Safety Article 13September 1993Book ReviewMitchell M. SimonFollow this and additional works at: https://scholars.unh.edu/riskPart of the Bioethics and Medical Ethics Commons, and the Insurance Law CommonsThis Book Review is brought to you for free and open access by the University of New Hampshire – School of Law at University of New HampshireScholars' Repository. It has been accepted for inclusion in RISK: Health, Safety & Environment (1990-2002) by an authorized editor of University ofNew Hampshire Scholars' Repository. For more information, please contact ellen.phillips@law.unh.edu.Repository CitationMitchell M. Simon, Book Review, 4 RISK 367 (1993).Book ReviewErratumThe citation for this review is 4 RISK 357 (1993) in most commercial databases.This book review is available in RISK: Health, Safety & Environment (1990-2002): https://scholars.unh.edu/risk/vol4/iss4/13Book Reviews 367MARC A. RODWIN, MEDICINE, MONEY & MORALS: PHYS-ICIANS' CONFLICTS OF INTEREST. (Oxford University Press1993). [430 pp.] Acknowledgements, acronyms, appendices, foreword, index,notes. LC: 92-49488; ISBN: 0-19-508096-3. [Cloth $25.00. 200 Madison Avenue,New York NY 10016.]In this reasonably priced and well-produced book, Marc Rodwinsets out to put the issue of physicians' conflicts of interest on the ethicaland health policy agendas. He certainly provides readers with thenecessary tools to understand the topic.MEDICINE, MONEY & MORALS traces questions surroundingphysicians' conflicts of interest and answers from the profession sincethe beginning of the century. It contains extensive citations and providesthe reader with sufficient materials to allow critical evaluation andcareful analysis of the author's thesis.I have found few, if any, books as readable as this to be as rich incitations and secondary materials. In fact, Rodwin's text occupies justover one-half of his book; the remainder includes useful appendices andextensive endnotes. In the few weeks I have had this book, I havereferred to it at least twice and used its references in my work.I was also impressed with the author's understanding and coverageof the conflict issues in managed care. It seems to me that the questionsraised by "specialist accounts" controlled by primary care doctors, andother incentives to refer to others too infrequently, raise issues for healthcare consumers at least as important as blatant incentives to overtreat.My only criticism is that the book seems to "play" much better forlawyers than physicians. In discussing its analysis of problems and theproffered solutions with friends who are doctors, I found more hostilitythan expected. I think, in part, this is because the author relies heavilyon the logic and argumentation techniques of legal thought. Forexample, Rodwin uses much reasoning by analogy, a mainstay oflawyers. It is probably not a fair test of the power of a work to ask thosewho are criticized to enjoy it, but my own interest in finding ways tobring the professions together compels lament.4 RISK - Issues in Health & Safety 357 [Fall 1993]Professor Rodwin concludes that, in light of the profession's failureto self-regulate, far-reaching legal interventions are needed. Thus, heaims his arguments at policymakers. However, I think he missed anopportunity to educate doctors who already feel attacked by legal andpolitical systems. His attempt at the end to show how removal of certaineconomic incentives will help create an ethos of caring that will benefitboth doctors and patients seems to be too little, too late.In conclusion, I think that Rodwin set out to persuade policymakersto control conflicts of interests. He has certainly done a fine job ofarguing his case and presenting material that allows those who disagreenevertheless to participate in the discussion. Despite what I believe to bemissed opportunities to do more, this is a solid achievement.With the review copy of the book, Oxford sent a page of otherreviewers' comments. As expected, their observations are exceedinglykind. Nevertheless, I agree with those who expect this to be the bestbook on the topic for some time to come.Mitchell M. Simon tt Mr. Simon is Professor of Law, FPLC, and Co-director, FPLC Institute forHealth, Law & Ethics.

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