Tuesday, March 23, 2010

Incentives Matter

[A]t a conference dealing with spine surgery, a surgeon presented the case of a female patient with herniated disk in her neck and pain that was caused by a pinched nerve. She had already failed typical conservative treatments such as physical therapy, medication, and waiting it out.
The surgeon asked the audience to vote for a couple of choices for surgery. The first was the newer anterior approach, where the surgeon removes the entire disc, replaces it with a bone plug, and fuses the discs. The vast majority of the hands shot up. The second choice was the older posterior approach, where the surgeon removes only the portion of the disc that is compressing the nerve. No fusion is required because the procedure leaves most of the disc intact. Only a few audience members raised their hands.
The speaker then asked the audience, which was entirely male, "What if this patient is your wife?" The show of hands reversed for the same two choices. The main reason is that the amount surgeons are paid for the newer and complicated procedure is typically several times what they'd receive for the older procedure.

Hmmm... Three points:
1) Incentives matter.
2) The audience in the above anecdote are very honest, I must say.
3) This story has nothing to do with my present condition (see here). It is pure serendipity. The above extract comes from Think Twice by Michael J. Mauboussin.

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