Interesting
What is also interesting to me is, my day job is as a writer/researcher in organized medicine (not the AMA, but a similar organization that reps a specific medical specialty; I work a lot with AMA people so based on the review, I recognize several of the "characters" as representing actual people I've worked with at the AMA, and I know the internal politics the book deals with very well, too. I think this book would lend itself well to the roman-a-clef format for the specific demographic of physicians and physician lobbyists, but perhaps mainstream publishers thought that was too narrow a demographic. Still, there are several million physicians in the US, most of whom are members of the AMA, so I'd think they'd want to read something like this.
As a fiction writer myself though, I know the fiction market is very tough these days. A lot of very high-quality fiction gets rejected by publishers, often over the opinions of editors, on the sole basis of marketing departments saying the books aren't "marketable." Maybe that happened with this book. Or, maybe it's just bad. Hard to tell.
