Book excerpt: This highly topical and controversial book presents a lively re-appraisal of the current changes to the health service and analyzes their effects on the status and practice of health professionals. Modern medicine is a powerful institution. With the help of highly-developed drugs and surgical techniques, it promises to relieve suffering, improve the quality of life and extend the life-span. Conversely, it is expensive for the governments, insurance companies and individuals who pay for it and sometimes appears to be insensitive to the needs of those for whom it provides. And while recent restructuring of healthcare delivery services has provided medical practitioners with new challenges, there has been very little consideration of the range of pressures that they now face. Edited and written by experienced medical sociologists, this book draws together analysis of a number of diverse challenges to medicine, and provides original debate on the challenges posed from within medicine from nurses and managers and alternative practitioners, and from outside by self-help groups, the women’s movement and the media.