Howell also shows how changes in medical practice raised issues of gender, culture, and economics. Howell's analysis is especially timely in light of the ongoing debate over U.S. health care reform, a debate in which a central topic is the use and expense of medical technology. In a concluding chapter he applies the book's historical insights to medical practice today—asking why, for example, modern diagnostic tests have not been used to give doctors more time to spend with patients.