Capo, you completely misconstrued my entire post. Obvously we have an obligation to the patient to provide the best care possible, but your idea of what is ethical or not is a little off. The ethical way of treating any surgical candidate is to exhaust all conservative measures first before taking that patient to the OR. There are plenty of malpractice lawyers out there who would jump at the opportunity to teach you that lesson the hard way. This is not "milking the insurance company", it is called standard of care and rushing into surgery will land you in court the first time you have a non-union or non-compliant patient. There are also plenty of other doctors who would be willing to take the stand against you and go on an on about how many conservative treatments should have been tried before surgery. Obviously there are cases that warrent a surgical procedure immediately but most (like my example of plantar faciitis)
must be treated conservatively first. The purpose of my post was to point out that simply wanting to do expensive surgical procedures may appear to be a great idea for you bottom line, but in all actuallity by treating your patient with the conservative standard of care you can still make a reasonable living while giving the patient the best treatment possible. This standnard of care appraoch to practicing medicine is the
most ethical and will keep you out of the courtroom and in your office seeing patients.