On a steamy August morning, my friend, Bethany, was playing tennis when she felt a small pull in her back. Thinking nothing of it, she continued with her game. The next morning the pull had become an ache, and within a week the pain had so intensified that she had to limit her activity to walking to the mailbox. She called her general practitioner (GP), the gateway to her HMO, but he was unavailable for two weeks. When she finally got an appointment, her GP told her to take Advil, rest for two weeks, and then call back if her back hadn't improved. Back pain, he said, often healed itself. When there was no improvement three weeks later, her GP suggested she see a neurologist about an epidural. The neurologist was not available until November, so the GP made a second appointment...

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