> It’s technically true that doctors need patients. But does anyone believe any doctor actually thinks in those terms? > Not just because it’s unethical. The

> It’s technically true that doctors need patients. But does anyone believe any doctor actually thinks in those terms? > Not just because it’s unethical. The mechanism doesn’t work: your future income will benefit a lot more from being regarded as a competent doctor, than it ever would from the minuscule damage you could do to public health with being purposefully bad. Almost none - certainly not when it comes to preventive care. The original article shows misaligned incentives with a tiny, short feedback loop, and even then these instances are (thankfully) not common on a large scale. The idea that a GP would encourage their patients to have unhealthy diets and never exercise, just so that in twenty years some other doctor - a cardiologist, endocrinologist, etc. - could have a greater supply of patients in need of care is absurd. The GP's expected lifetime earnings are not going to go up if their patients decide not to engage in preventive care, and the GP's expected lifetime earnings definitely will go down if they actually discourage preventive care, because they'll develop a reputation as a shoddy doctor.