"The Procedure" in question is a method of ensuring fidelity by couples who are between, say 35 and 60 years old, and who are experiencing angst in their lives that's generated by the indifference that inevitably accompanies over-familiarity. One of the characters in the novel is a Doctor with four medical degrees (plus many honorary ones) and at one stage in her life she was employed as the Visiting Physician in a Fertility Clinic and she soon realized that many of her patients were experts in ways of increasing the frequency, and the potency, of their husbands' attempts to meet their goals of getting pregnant. She takes many notes and they come in handy, much later, when she's called in by the President of the USA and asked to find a way to ensure that one of his high government officials, whose very life depends on keeping her man happy and faithful over the long term, is provided with a way to achieve that end. Later still she realizes that one of her "Procedures" (they've been increased to three in number to help couples from 60 to 90) and so she publishes them in a pamphlet which quickly goes 'viral'. The reason that it takes better than 400 pages to get to describe these PROCEDURES is because the three main characters need extensive, interlocking, biographies to explain how she, the good Doctor, accumulates the experience and the knowledge needed to accomplish her innovative project. If women read the text on the back cover they'll probably want to read the whole book and if men read the Dedication - DITTO!