# In medical systems that reward doctors for patient outcomes, how to avoid cherry picking patients

**URL:** <https://boards.straightdope.com/t/in-medical-systems-that-reward-doctors-for-patient-outcomes-how-to-avoid-cherry-picking-patients/827908>\
**Category:** Factual Questions\
**Created:** [January 17, 2019, 1:48am UTC](https://boards.straightdope.com/t/in-medical-systems-that-reward-doctors-for-patient-outcomes-how-to-avoid-cherry-picking-patients/827908 "2019-01-17T01:48:22Z")\
**Posts on this page:** 2\
**Page:** 2

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**Author:** ![ENugent](https://avatars.discourse-cdn.com/v4/letter/e/4af34b/32.png) [@ENugent](https://boards.straightdope.com/u/ENugent)\
**Post date:** [January 19, 2019, 5:33pm UTC](https://boards.straightdope.com/t/in-medical-systems-that-reward-doctors-for-patient-outcomes-how-to-avoid-cherry-picking-patients/827908/21 "2019-01-19T17:33:28Z")

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> [@bump](#):
>
> What are you talking about? If a doctor say… refers a patient to an ultrasound imaging clinic, there’s not any quid pro quo there. It’s a one-way thing, and the patient ends up paying the ultrasound clinic for the procedure, not the doctor.

My understanding is that many doctors refer to specific labs and other facilities in which they have a financial interest.

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**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\
**Post date:** [January 19, 2019, 5:40pm UTC](https://boards.straightdope.com/t/in-medical-systems-that-reward-doctors-for-patient-outcomes-how-to-avoid-cherry-picking-patients/827908/22 "2019-01-19T17:40:00Z")

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> [@panache45](#):
>
> This is exactly what happened to me, regarding spinal stenosis. After getting little help from several doctors, I went all the way to the top, to the head of the spinal surgery department. After reviewing my case, he informed me that he couldn’t operate on me because the surgery would be too risky. What he meant wasn’t that it would be risky for ME, but risky for HIM. If I died on the table, it would ruin his stellar performance record. The only patients that he’d operate on were patients who had absolutely no medical issues other than spinal stenosis.

What did work for your stenosis? Did you get surgery eventually, or was it controlled via conservative measures?

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