The day his father died, Dr. Solomon Forte promised his mother he would honor his dad’s memory by dedicating his years as a doctor to the treatment of injured workers. It seemed so clear a decision—his patients would be like his dad, stoic, honest, working class stiffs who sought nothing more from a doctor than an arm around the shoulder, a word of reassurance, and an ally in dealing with the state industrial insurance system. His life at the Whitaker Hospital and Medical Center is, though, the antithesis of his dream. He can’t tell which of the roadblocks is most daunting: that posed by his medical colleagues, the threats of S.M.A.C., the State Medical Abuse Commission, the bureaucracy at C.O.L.A., the state’s Commission on Labor Affairs, or the duplicitous patients, some of whom spend every waking moment trying to dupe him out of drugs and government benefits. C.O.L.A. also examines the specter of serious medical errors, and how they are so much easier to make on patients whose care is mired in the aggravation of government-sponsored insurance plans. Questions are also raised about the state-appointed morality commissions that determine which doctors relinquish their licenses for treating pain.

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