Medical economics is complicated. Reimbursement to physicians, facilities and manufacturers often defies logic.
In a recent editorial, I stated that when I started practice 4 decades ago, there were only two parties in the examination lane and surgical suite: the patient and the physician. We physicians in that simpler time personalized a treatment plan for each individual patient, educated the patient concerning risks, benefits and alternatives, and trusted that payers would reimburse in a reasonable and customary fashion.
Today, there are three parties present during every physician-patient