Incentives have a powerful effect in healthcare: - Physicians want to avoid getting sued - Physicians want to get paid , just like everyone else. - The payor i

Incentives have a powerful effect in healthcare: - Physicians want to avoid getting sued - Physicians want to get paid , just like everyone else. - The payor in the system is not the patient, but a faraway entity removed from the situation on the ground. In such instances, all 3 factors influence a decision. If a decision to perform procedure X is close to 50/50 (test/no test) Do you think "no test" will win ? Now put that in the macro context of millions of patient visits. now, since we are talking diagnostic testing, you may need to be tested at a hospital. So now, you are voluntarily exposing yourself to a hub of tired doctors/bureaucracy/germs. That starts looking like madness , for sure