The real reasons behind complex surgical procedures.

The further that I read into Whittle and colleagues’ editorial on patients’ optimism about percutaneous coronary interventions, the more the suspense grew. Imagine my surprise when I found no real reference to the effect of the cardiologist’s needs and wants on the frequency of the procedure being offered. The more powerful person in the therapeutic relationship is the doctor, not the patient, so why are so many patients having procedures with benefits that they poorly understand? Don’t look at the patients to find out why. Instead, examine the doctor’s motivation. In some parts of the world it is as simple as money (fee per procedure). In others it’s a more complex aggregation of pride, technical complexity, and the challenge associated with the procedure, not to mention the social and professional plaudits that go along with saving lives every day. Patients think they are having life saving procedures because medical professionals want them to believe that this is so.