Unnecessary Surgery
Next in a series describing how and why unnecessary, and possibly risky, procedures can occur
Another subtle cause of unnecessary medical care is pressure from colleagues. When many physicians own shared assets, collectively, they tend to push each other to use these assets. Such situations arise with physician owned surgery centers, imaging centers, or physician owned distributorships (PODs). In these arrangements, many doctors may benefit from the work of each physician. Therefore, many voices can be heard reminding every doctor to increase the volume of work sent to, or used by, the collectively owned center.
For instance, if a physician owned surgery center reserves operating time for a surgeon, and he fails to utilize this time, all physicians who own the center are adversely affected; their incomes from the center decrease. Alternatively, all owners benefit when any doctor increases the amount of work that he/she does at the center. Therefore, doctors working in collectively owned surgery centers are subject to what I've called "collective greed". A physician often feels more pressure to do unnecessary work in such a center than he would in an individually owned surgery center or if he worked at a not-for-profit hospital. Pressure to increase surgical volumes includes loss of operative time, loss of ownership interest at the center, and loss of professional standing among colleagues.
This same phenomenon occurs at most big Wall Street firms when they divide up the employees' share of annual profits. They, too, find that employees motivate each other to sell more financial products when all employees share one large pot of money. Their bonus system is effective in encouraging all eligible employees to push each other to make as many and as profitable trades as possible. While this works on Wall Street, I am doubtful that this type of motivation is in the best interest of patient care.
Another subtle cause of unnecessary medical care is pressure from colleagues. When many physicians own shared assets, collectively, they tend to push each other to use these assets. Such situations arise with physician owned surgery centers, imaging centers, or physician owned distributorships (PODs). In these arrangements, many doctors may benefit from the work of each physician. Therefore, many voices can be heard reminding every doctor to increase the volume of work sent to, or used by, the collectively owned center.
For instance, if a physician owned surgery center reserves operating time for a surgeon, and he fails to utilize this time, all physicians who own the center are adversely affected; their incomes from the center decrease. Alternatively, all owners benefit when any doctor increases the amount of work that he/she does at the center. Therefore, doctors working in collectively owned surgery centers are subject to what I've called "collective greed". A physician often feels more pressure to do unnecessary work in such a center than he would in an individually owned surgery center or if he worked at a not-for-profit hospital. Pressure to increase surgical volumes includes loss of operative time, loss of ownership interest at the center, and loss of professional standing among colleagues.
This same phenomenon occurs at most big Wall Street firms when they divide up the employees' share of annual profits. They, too, find that employees motivate each other to sell more financial products when all employees share one large pot of money. Their bonus system is effective in encouraging all eligible employees to push each other to make as many and as profitable trades as possible. While this works on Wall Street, I am doubtful that this type of motivation is in the best interest of patient care.
