The book also makes little mention of carve-out companies and the practical questions that arise around them. For example, should clinicians seek to work for all of them? Is it ethical to belong to a network to see ongoing patients, yet refuse new patients from that organization (while accepting new patients from better payers)? Who is responsible for "phantom networks"—irresponsible psychiatrists, or managed care companies who insist on much paperwork and low clinician reimbursement? What about managed care-driven split therapy, whereby a psychiatrist works with psychotherapists selected by the managed care company—does one accept all arrangements? None of these messy issues appears in the book, although there is a good discussion about how to go about appealing managed care denials.