In this issue of JAMA, Eappen et al1 reach the troublesome but not surprising conclusion that hospitals in the United States can profit handsomely from postsurgical complications, even if the hospitals could avoid them. The authors note that “Effective methods for reducing surgical complications have been identified. However, hospitals have been slow to implement them.”
Although the authors do not expressly say so, readers may infer that the associated financial losses may discourage hospitals from reducing avoidable postsurgical complications as vigorously as they could. This brings to mind Shaw's famous lament in his play The Doctor's Dilemma that “[i]t is not the fault of our doctors that the medical service of the community, as at present provided for, is a murderous absurdity. That any sane nation, having observed that you could provide for the supply of bread by giving bakers a pecuniary interest in baking for you, should go on to give a surgeon a pecuniary interest in cutting off your leg, is enough to make one despair of political humanity.”2
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JAMA 2013-04-16, Vol. 309, No. 15, Author Audio Interview Part II
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