Conclusion: The consistent finding of higher use rates by physician owners across time clearly suggests that financial incentives linked to ownership of either specialty hospitals or ambulatory surgery centers influence physicians’ practice patterns.
This is why we need care guidelines that dissociate the recommendations for procedures from the financial incentives of those that provide those procedures. I'm not saying that physicians are intentionally recommending unnecessary surgeries, I believe the effect is more indirect. Instead, I'm suggesting that the way the system, and the incentives, are set up will influence the beliefs of practicing physicians leading them to prescribe treatment differently than they would in another system. This can't be fixed without systemic change.