Intern, Maggie Altman, begins her postgraduate training in a large Texas hospital where a new computerized system has been implemented to improve service. She pours heart and soul into her work, but her admissions always seem to be the sickest patients who keep dying, sometimes inexplicably. Maggie becomes suspicious of her colleagues and of Dr. Milton Silber, an irrascible, retired clinician with no fondness for the new technology. Silber also happens to be a financial genius. Overhearing conversations and finding puzzling papers, Maggie imagines a scam, in which her supervisors may be eliminating dying patients to reduce costs, improve statistics, and siphon funds to their own pockets.

The bad outcomes for Maggie's patients are noticed and criticized, and she is pressured to drop out, switch hospitals, or go back into research. She senses that the perpetrators are aware of her suspicions and send her the worst patients in an effort to eliminate her. She trusts no one. These worries are compounded by her own illness and her accidental discovery in the morgue of a traffic in unclaimed bodies. With the help of excellent clinical skills, true friends, Dr. Silber, and a new love interest who is a budding financial genius, she survives physical and emotional violence and solves the mystery of patient homicides, poisonings, and fraud.


A science fiction thriller that trades on the evil spectre of hospital bureaucracy, which, with its exaggerated emphasis on statistics and money, twists good doctors and further corrupts bad ones. Sutton's Law of the title refers to a famous quote from bank robber, Willie Sutton who when asked why he robbed banks, replied, "Because that's where the money is." It is much used in medicine as a pearl of wisdom to guide clinical decision making. In this story, heroic pluck unites with clinical and fiscal wisdom against the horror of managed care.

On one level, the book is a diverting mystery that challenges medical readers; on another, it can be seen as a polemical criticism of current trends in hospital management. The first author is a fiscal conservative and a prominent American physician specialized in internal medicine who did her undergraduate degree in mathematics and her medical training at Columbia. Prominent in debates over health policy and ethics, Dr. Orient has been Executive Director of the Association of American Physicians and Surgeons, and was responsible for bringing a successful lawsuit, AAPS vs. Clinton, against the Clinton Task Force on Health Care Reform. The author of more than 100 articles in scientific journals, she has delivered many speechs, voicing her objections to government involvement in health care delivery and demonizing the "socialism" of Canada.

In addition to its entertaining qualities, her thriller can be read as an attempt to elevate awareness and engage dialogue in these issues. For more on Dr. Orient's perspectives on health care, in which she sometimes refers to Sutton's Law, see her 1998 submission to the Submmittee on Commercial and Administrative Law:


Hacienda Publishing

Place Published

Macon, Georgia



Page Count