Dr. Denise DeLuca is in medicine for what she can get out of it, not what she can give. She is enabled by incompetent hospital administrator Royce Wexler, who in turn works for a corporate hospital system with a focus on the bottom line first, and patients second. When an ambulance hits famous Bicentennial first-born baby Flip Jenson in front of the Ascend Medical Center emergency room where he was born 23 years earlier it brings out the worst in Dr. DeLuca. She scrambles to cover her growing trail of dysfunction. A local television reporter who wants to move onto a bigger news market sees Dr. DeLuca as her way out of Charlottesville, VA. That is if she can unravel Dr. DeLuca's intrigue and the actions of the hospital that protects her. Medical Necessity explores the power structure of hospitals and the relationship between medical staffs, administrators and boards of directors. A cast of characters keeps the story lively - from a narcotic pain pill-seeking hustler to a handsome ladies man born without arms. The story is set in the late 1990's. These were the last days of a healthcare era when physicians, insurance companies and hospitals amassed huge fortunes working in a fee-for-service money environment, largely free of any quality-of-care requirements. Medical Necessity tells a story of what happens when institutions and the people in charge are not held accountable.