demonstrating how informed and persistent patients can make the best of an imperfect system. I expect her discussion of the doctor-patient relationship will embolden many a person to speak up, demand what is needed, or change doctors if necessary. Her chapter on internet medicine should be a wake-up call to physicians. In this age of information overload, it's impossible for a physician to be an expert on every disease. We need to find better ways to work together without feeling threatened. As the author points out, individual patients have more time to research their own condition than does a physician. I, too, have had patients help diagnose their own problems by sifting through hours of medical information. I appreciate Elizabeth's advice for patients to seek out trusted web sites (which she identifies), and how to approach your physician with a summary of the information. Again and again throughout the book I was struck with how time pressure undermines our current health care system. Doctors are compelled to crank out patients, at least if they want to stay in business. Hospitals are understaffed, leading to communication problems and treatment errors. Although physicians may grasp a plan of therapy for an individual within minutes, it takes much longer for a patient to comprehend something new and unfamiliar. Payment is determined largely by documentation, and if forced to choose between direct patient care and documentation, professionals (who need an income) are forced to choose the latter. I appreciate how the author has chosen