Unlike many normally scary things in life (terrorism, dark basements, creepy alleyways) this actually scares me. Industries that have a profit motive to find something wrong are often the ones that we have to turn to when we are at our most vulnerable – doctors, dentists, electricians, plumbers, contractors, mechanics, etc. As a female I was taught to be extra vigilant when taking my car to a mechanic because it was notoriously easy for an ignorant female to be sold repairs or upgrades that weren’t actually necessary. To guard against this, I took an automotive repair class and taught myself how to do basic repairs to my vehicle. But in thinking about this, I realized two things: 1., that mechanics were not the only area in life where someone can capitalize on another’s ignorance, and 2., just because they can, doesn’t mean that all do (and 2.a., I suppose: just because they do, doesn’t mean that they are doing it for the wrong reasons).
The medical profession is one where this is a particularly insidious problem, and is one that contributes to the rising costs of health care. Here is the scenario: a patient comes in complaining of headaches. The most likely cause is, say, muscle tension, which contributes to migraines and sudden onset headaches. However, there is a 1% chance that it is a brain tumor. Does the doctor prescribe muscle relaxers and send the patient on his way? Or should he order an MRI just to make sure? The former earns the doctor $100 for an office visit, but the latter could earn the doctor thousands of dollars. If he does the former and it does turn out to be brain cancer, it could result in a malpractice lawsuit for the doctor. But if he orders the latter, what is the harm? Besides costing the patient time and money? In many cases he could even ask the patient, and they would consent to an MRI because the threat of brain cancer is so scary. But what if the doctor’s information is out of date and the threat of brain cancer is only .5%? This is a relatively simple thought question, but this scenario is played out hundreds of thousands of times across the US a day, and in many cases instead of a non-invasive MRI the most extreme medical option is surgery or other type of intervention. Millions of people could be undergoing unnecessary tests or operations because doctors have a financial incentive to treat the worst case scenario and most people are ignorant about the real health risks they are facing or their rights as a patient. No one is doing anything “wrong,” per se, but I think most would agree that a wrong is being done.
In the end we have two choices: somehow re-engineer the system so the profit incentive to find something wrong is fixed across all of these industries (so mechanics will stop trying to sell me a coolant flush) or educate ourselves as consumers of these services.