With its focus on doctors’ conflicts of interest, the book addresses a salient yet neglected issue in health policy. Healthcare reform in industrialised countries rarely focuses explicitly on conflicts of interests, at the same time such conflicts are inherent across healthcare systems. This reflects the fact that all health systems, although to different degrees, rely on a combination of elements of the state/public regulation, private industry/the market and professionalism as a form of private interest government. As such, the book addresses a topic which is highly relevant both from empirical and theoretical perspectives, not least also as the author adopts a cross-country comparative perspective and includes the US, France and Japan.

The book starts with fictional patient stories from the three countries. This makes for a powerful illustration of the potentially severe consequences of conflicts of medical interest and thus underlines the concrete relevance of the book. The patient stories also demonstrate the considerable diversity of treatments for the same condition and how system level differences in the organisation of health services shape the regulation of doctors’ ties to industry. This is followed by an introduction (Chapter 1), which sets the scene for the subsequent presentation of the country case studies, which constitute the main body of the book. More specifically, the chapter discusses the definition of conflicts of interests and introduces a range of key circumstances under which conflicts of interest occur. France is an example where organised medicine is key, whereas the US is a case where markets dominate, while Japan is an example where doctors own most medical facilities. This shapes the nature and extent of conflicts in different ways. The book presents the countries as separate case studies, following the same two-part structure, looking at the historical evolution of medicine and at the coping strategies for conflicts of interests. In contrast, the more detailed structure of the individual case studies follows the specific characteristics of the respective country, for example with the review of the historical developments going back to medieval times in France and the 1950s in the US. Similarly, the US case study is very detailed and spread over four chapters (Chapters 4–7), whereas the analysis of France and Japan are considerably shorter (Chapters 2–3 and 8–9, respectively). The analysis of the three countries is followed by two chapters grouped together under the heading ‘implications’, which set the focus on different possible reform measures, which are assessed in terms of whether or not the individual reform measure is likely to reduce conflicts of medical interest. This discussion draws on the preceding country case studies as illustrative examples. In substantive terms, Chapter 10 looks at reform measures concerned with changes in the organisation of health services, readjusting elements of public regulation, markets and private interest government. The latter is dealt with in more detail in Chapter 11, which turns to professionalism itself and discusses how professionalism can be tweaked to minimise conflicts of medical interest. Considering the preceding analysis, it is not surprising that the author rejects relying on professionalism alone, as the early sociology of professions suggested. Instead, the author advocates an embedded form of professionalism, where both the state and the market provide necessary checks and balances. This provides the springboard for the conclusion, which makes a plea for a division of labour between public regulation and professionalism.

Students and researchers in comparative social policy and health policy will be particularly interested in the discussion of the regulatory challenges involved in balancing public control on the one hand and private interest government on the other; they will also find some of the country case study material useful. However, this audience will miss a number of things: a more explicit and theoretically based framework of the analysis which also structures the analysis itself; a more thorough and critical discussion of the cross-country comparative approach and the choice of countries; a stronger comparative analysis of the country case study material as well as a more systematic identification of similarities and differences across countries and of how contextual factors account for the differences found; and based on these a more critical analysis of the possibilities and limitations of learning across countries. Nevertheless, this is an important book; it addresses a salient yet neglected issue in health policy and which is also crucial for delivering high quality health services. As such, the book will be of particular interest to the medical community as well as political decision makers. The fact that author writes extremely well makes the book particularly accessible to this audience.