House of God is indeed an interesting book and a good read. I read it during second year of my residency, and it is incredibly sad how the stuff that is talked about in the book has gotten worse in some ways, though better in others.

I'm actively against the "bowel run" mentality. I do my best to avoid even the CYA test ordering, though I'm not in the ED where this can be the most rife. I see first hand the "ponzi scheme" (though IMO it is not the correct term) of the system and I chose to go into primary care because I actively want to fix this in any way I can, and being a specialist was not the way I thought would be best to do this.