A practitioner's observations and ruminations on strengths and weaknesses in the medical care system--along with possible reforms. Robin is also a teacher, researcher, and past-president of a specialty organization (the American Thoracic Society). His major premise is that some basic processes in the diagnosis and treatment of medical problems are seriously flawed. Foremost among these is the inadequate use we make of risk-benefit analysis. Doctors and patients should recognize that most medical care involves potential risk as well as benefit--and that decisions can be made by weighing their relative weight. Today, such decision-making is impossible became the necessary data doesn't exist for most diagnostic and therapeutic procedures. One of Robin's most impassioned arguments, therefore, is for strong clinical trials in every area to make up the deficiency. (He explains at length how existing data is skewed, misinterpreted, or otherwise faulty.) Robin also raises other concerns--patient ignorance, for one--with examples of how the system perpetuates the problem. Much of this is open to argument, and there are large holes in some proposals. A modest work like this nonetheless has the value of bringing before the public still another distinct medical view of reform.