On my summer reading list is Mark Rodwin's Conflicts of Interest and the Future of Medicine . One specific manifestation of the broader problem is illustrated in an article in today'sPittsburgh Tribune-Reviewthat discusses the role of money on end-of-life treatment. "Hospitals and doctors make more money by aggressively treating terminal patients than by keeping them free of pain and letting them die with dignity."
Dr. Gail Gazelle explained: "It's impossible to remove money from the discussion because doctors are paid more to treat — not talk. . . . "Physicians are reimbursed much, much, much, much less for actually communicating." Dr. David Goodman similarly explained: "Money is an unconscious influence that we as professionals can't pretend doesn't exist. . . . It's like being in a slow-moving but powerful river, where the current is hard to overcome. You might not even be aware of it, but you can't deny that it's there."