I seem to have touched a nerve

It seems that whenever I question the way physicians practice, I make some new enemies. I should know better by now. My father, a retired surgeon, and I have had some of our most passionate arguments on this issue. He’s absolutely positive that he never, ever let financial considerations come into play with respect to patients.

Let’s be frank here. I’m a physician. Many of my best friends are physicians. I have family members who are physicians. The vast majority of doctors I know are passionate, dedicated, and want to do good.

That still doesn’t mean that money doesn’t influence them on some level.

There’s a reason that ten cent coupons work. Financial pressures, even tiny ones ones, work. This isn’t me being “emotional”. There’s a large body of evidence at work here. Here’s a study which shows physicians care about patients and money when making treatment decisions. Here’s another that shows that compensation schedules do influence physician practice patterns.

This doesn’t mean that physicians are bad people, or even weak. They’re human. And our whole system of economics is driven by the concept that humans are influenced by the idea of making money.

What we need to do is recognize this, accept it, and work to minimize its influence. What we don’t need to do is deny it and pretend that we are superior beings who are immune.

When relatively few physicians think they can be influenced by drug companies, but that most other physicians can, that’s delusional. And when only 3% of physicians think money drives their practice, but that most other physicians would be influenced by money, that’s delusional too.

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