Starr's book is one of the landmarks in the history of medicine. Using a framing theory of professional authority and a desire for independence, he examines medicine in America from the late Colonial period up through 1980. This book is sometimes overwhelming, but rarely obscure, and useful for both scholars and interested laymen. Starr explains the major periods of American medicine (disorder and disrepute to about 1870, standardization and professionalization from 1870 to WW2, and specialization and conglomeration after WW2) and their broader social and political contexts in education, public health, hospitals, and how doctors are paid.

Obviously, this book doesn't cover the past 30 years, and Starr is interested more in the character of a defined era than the actual moments of transformation, which to be fair, may be too elusive to really observe in a historic sense. But for anyone interested in why American healthcare is so expensive and why it is so resistant to reform, this is a definitive history.