Whether or not a medical procedure is “needed” is somewhat analogous to the distinction between major and minor surgery.
Minor surgery implies low risk, little pain and a quick return to normal life.
Major surgery is any surgical procedure performed on me.
Most people who show up at the doctors office expect things be done to address their complaint. They are not comforted by the line, “it is statistically unlikely that there is anything seriously wrong with you, therefore, we aren’t going to check out any of your complaints.”
If one goes to the doctor with an ailment, the expectation is that the doctor will do what is necessary to diagnose and treat the ailment. Otherwise, why go?
The doctor’s responsibility is to the patient - not to the insurance company, not to Medicare drones (roots of this are in the Hippocratic Oath). There is no question that current third party payment methods take most of the immediate cost out of the discussion for the patient. But that is not the fault of the individual doctor or patient, and does not change the facts of what the doctor is responsible for.
Ezekiel Emmaneul, Rahm Emmmanuel’s brother (a physician), has written that docs need to abandon the Hippocratic Oath and its placement of the patient’s good as the doc’s main focus, to be replaced by “societal good” and the “management of society’s resources” (not quoting him directly). If that happens, understand the doc is no longer working for you.
Emmanuel bros sound evil