An Urgent Call to Action Against Greed


A JAMA editorial by Donald Berwick, M.D., talks about “the existential threat of greed in American healthcare.” He points his finger at all segments of healthcare, including physicians.

In my vascular medicine specialty, I have encountered many physicians who overtly and repeatedly urge their patients to undergo a saphenectomy, even though my examinations show that the saphenous vein is completely normal. These are often poor and uneducated patients at the mercy of their doctors’ unscrupulous behavior. Some of them have peripheral arterial disease and may need these veins for bypass conduits I would report her one of the most egregious offenders to the Medicare Fraud Center but so far it’s failing.

Then there is a cardiology colleague who ordered annual nuclear scans for my patients. This includes patients who were completely asymptomatic and who did not meet the accepted indications for such a scan. I started arming my patients with Wisely’s literature. It was stressful. There’s an excellent white paper about many things.

According to multiple studies, physician income does not correlate with career satisfaction. A Medical Economics study found that pediatricians and psychiatrists were among the lowest earners among us, yet had the highest satisfaction. In contrast, orthopod satisfaction was at the bottom of the chart.

Historically, doctors are among the top ‘noble professions’. This is due to consideration for others, trustworthiness, and being essential to society. But when “greedy” is added to this list of physician traits, we quickly lose our exalted status in the eyes of society and among ourselves.

We doctors have to challenge ourselves wherever greed comes to mind, whether it’s pharmaceutical companies, insurance companies, hospitals, members of our house. Mostly retired, except for volunteering at clinics that provide services free of charge to people with disabilities. We will have to resort to similar clinics as a means.

Don Guede is a physician.


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