The Law of Unintended Consequences
In the idealized vision of healthcare, every decision a doctor makes is driven by the purest motives: the well-being of the patient, the pursuit of healing, and the oath to “do no harm.” But in the real world, medicine operates within a complex web of incentives and pressures. Systems like Relative Value Units (RVUs), which tie physician compensation to productivity metrics, and pharmaceutical industry incentives, which subtly influence prescribing habits, add layers of complexity to the already challenging practice of medicine.
What happens when doctors, who are as human as the rest of us, navigate systems that reward the volume of care over its quality? The answers can be unsettling. As the story of one oncologist in Montana reveals, these systems can unintentionally encourage practices that undermine patient outcomes, tarnish trust, and compromise the very mission of healthcare. This article explores the unintended consequences of these incentive structures and why they matter not just for doctors, but for all of us who rely on them when we are at our most vulnerable.
(Note: About Us, a reference bibliography, related books, videos and apps can be found at the end of this article.)
