MEDICINE GOES CORPORATE

A novel about a Midwest medical center cites its propensity for corruption and unethical decision-making.

Spenser, a veteran physician, appears to have loosely based his novel on his own investigation into shocking health care inequities. The lead, Jack Spenser, has lived in Pathfinder, a small, bucolic Midwestern town, since his birth in 1949. He watches the population and its economy grow, while “the town and city kept getting closer together,” and ever encroaching American corporations continue to proliferate. Our hero always believed strongly in liberty, freedom, and equality, and his ambition and keen desire to serve the community lead him to medical school. Working as a pathologist at Pathfinder’s only hospital for four decades, the doctor observes that operations at Excel Pinnacle, “a beacon of good medical care,” run smoothly. He discusses his pathology work and notes the medical center’s excellent reputation. But the health care ecosystem he admires, which he equates with the dynamics of a coral reef, begins to fall out of balance thanks to the interference of large corporations, which are on a never-ending mission to cut corners and consolidate. When this consolidation process begins, Jack foresees that the hospital infrastructure, employee morale, and particularly patient care will all deteriorate as a result. The novel, as told from Jack’s perspective as an active physician entrenched in the system, also depicts a variety of medical professionals who become affected by the corporate takeovers and Excel Pinnacle’s greed. First, the emergency department is taken over, then the hospitalists, and once word leaks, the remaining employees panic as conjecture spreads. Jack’s conclusion that “physicians shouldn’t be that easy to push around” is followed by chapters of smoldering frustration, whirlwind corporate corruption, surprise audits, and, eventually, aggressive push back from Jack and his associates, which threatens to bankrupt them financially and emotionally.  

As a working physician in private practice, Spenser passionately details the ways the medical industry strikes deals with other, more predatory, business groups and how serpentine these damaging affiliations can become. Some of the patient cases, technical explanations, and jargon enmeshed in the conundrum are explicitly described and perhaps best appreciated by medical industry veterans who understand and most likely share Jack’s perspective. There are plenty of diatribes to sort through, courtesy of a protagonist who openly shares opinions and frustrations. Astute readers will discern that the novel’s core themes are reflective of real-life concerns about corporate conglomerate assimilations and the profit-above-all nature of corporate takeovers. Also on the docket are gripes about how technology creates more expense for smaller medical practices that often can’t afford to keep up with the newer digital upgrades required by the industry. This inability to conform leads the large wealthy corporations to come in and consolidate groups of physicians, Spenser attests. The best aspect of Spenser’s book is its believability and how convincing Spenser’s protagonist becomes as the story progresses; a conclusory note suggests the work is autofiction. Readers interested in the vexing, widely criticized American health care industry are in for a wide-eyed education in this reality-based story of greed and corruption.

A taut amalgam of medical thriller and convincing exposé about medical industry kingpins and exasperated physicians.