A hospital is supposed to be a place where human life is protected, illness is treated, and suffering is reduced. A patient enters a hospital carrying pain, fear and hope, often believing that the doctor sitting across the table will recommend what is medically best for the patient not what is financially best for the hospital. That trust is one of the most important foundations of medicine. But what happens when the financial health of a hospital begins to compete with the physical health of the patient?
A video circulating on social media has raised precisely this concern by arguing that, in general terms, unnecessary or unwanted surgeries could be considered a way to increase hospital income. Since the specific video has not been independently verified, it would be unfair to identify or accuse any particular person or hospital on the basis of a social-media clip alone. But the broader issue raised by such a statement deserves serious public discussion. Medical overuse, including unnecessary tests and procedures, is a recognised concern in healthcare systems around the world. The fundamental principle should be extremely simple: a patient should undergo surgery only when it is medically necessary and the expected benefits justify the risks—not because a hospital needs more revenue.
Surgery is not an ordinary commercial product. It involves the human body. It can involve anaesthesia, bleeding, infection, complications, disability, prolonged recovery and, in some circumstances, death. Even when an operation is technically successful, the patient may face weeks or months of recovery, lost wages, emotional stress and additional medical expenses. If someone buys a product they do not need, they may lose money. If someone undergoes an unnecessary operation, they may lose part of their health.That is why the question of unnecessary surgery should never be treated as merely a business or accounting issue. It is an ethical issue, a patient-safety issue and, ultimately, a human-rights issue.
The vast majority of doctors and nurses enter the medical profession to help people. Millions of healthcare professionals work under enormous pressure every day and make difficult decisions in the best interests of their patients. It would therefore be wrong to suggest that hospitals and doctors generally recommend unnecessary treatment simply for financial reasons. But that does not mean the healthcare system should ignore the possibility of financial incentives influencing medical decisions.A system can create incentives even when individual professionals believe they are acting appropriately. If hospitals depend heavily on procedure-based income, if doctors are rewarded according to the number of procedures performed, or if institutional financial targets influence clinical decisions, there can be pressure—direct or indirect—to increase the volume of treatment.That is precisely why safeguards are necessary.
One of the strongest safeguards available to patients is the right to seek a second medical opinion. When a patient is told that surgery is necessary, there should be nothing wrong with asking another qualified doctor to review the diagnosis and recommendation. A responsible doctor should not be offended by a patient asking questions about a major medical decision.Patients should be able to ask: What happens if I do not have this surgery? Are there non-surgical alternatives? What are the risks? What are the expected benefits? Is the surgery urgent, or can I safely wait? What does the medical evidence say?These are not disrespectful questions. They are responsible questions.
The problem becomes particularly serious when patients are frightened into accepting treatment. A vulnerable patient sitting in a hospital room may not understand medical terminology. When someone hears words such as “danger,” “blockage,” “complication,” “tumour,” “risk” or “urgent,” fear can take over. A frightened patient may simply agree with whatever the doctor recommends.That is why genuine informed consent is so important.
A patient should be given enough information to understand the diagnosis, the proposed treatment, the expected benefits, the possible risks and reasonable alternatives. The patient should have an opportunity to ask questions and, where medically appropriate, seek another opinion. Consent obtained through fear, pressure or deliberate withholding of important information cannot represent the spirit of genuine patient choice.
Another important issue is transparency around financial relationships. Whenever the person recommending a procedure has a direct or indirect financial interest in that procedure, patients deserve appropriate transparency. If a doctor, hospital, diagnostic centre or other healthcare provider has financial arrangements that could influence treatment recommendations, strong ethical safeguards are necessary.The healthcare profession cannot allow medical judgment to become subordinate to corporate accounting.
The problem is particularly serious when medical institutions begin measuring success primarily through the number of procedures performed rather than the health outcomes of their patients. A hospital should not be asking only how many operations it performed during a month. It should also be asking how many patients genuinely benefited from those operations, whether complications were reduced and whether patients received the least invasive effective treatment.A good healthcare system should measure outcomes, not simply volume.
The question should not be, “How many surgeries can we perform?”
The question should be, “How many patients can we make healthier without exposing them to unnecessary risk?”That is a completely different philosophy.Medical treatment should always begin with the patient—not the hospital’s revenue target.This issue becomes even more serious for middle-class and low-income families. Medical treatment can already be extremely expensive. A family may have to borrow money, sell property, use retirement savings or take loans to pay for hospital treatment. If an unnecessary procedure is performed, the family can suffer both financially and physically.An unnecessary operation can therefore hurt a family twice.It can hurt the patient’s body.And it can hurt the family’s financial future.
The psychological damage can also be enormous. If patients later discover that they may not have needed a particular procedure, they may lose trust not only in one doctor but in the entire healthcare system. That loss of trust can have dangerous consequences. Patients may delay genuine treatment, turn to unqualified practitioners or follow unproven medical advice circulating on social media.The answer, therefore, is not to create suspicion against every doctor or hospital.The answer is transparent healthcare.
Patients should have access to their medical records, diagnostic reports and scans. They should be able to understand what has been diagnosed and why a particular treatment has been recommended. Hospitals should clearly explain treatment costs and, where appropriate, provide information about alternatives.
There should also be stronger systems for identifying unusual patterns of medical procedures. If one hospital performs dramatically more of a particular operation than comparable hospitals treating similar patients, that should not automatically be interpreted as proof of wrongdoing. There may be legitimate medical reasons. But unusually high procedure rates should raise questions and, where necessary, trigger independent review.
Why is the rate higher?
Are the patients genuinely different?
Are there legitimate medical reasons?
Are evidence-based guidelines being followed?
Are patients receiving adequate alternatives?
Are financial incentives influencing treatment decisions?
These are reasonable questions for regulators to ask.The public also needs greater medical awareness. Patients must understand that more treatment does not necessarily mean better treatment. More scans do not automatically mean better healthcare. More medicines do not automatically mean better health. More hospitalisation does not automatically mean better recovery. And more surgery certainly does not automatically mean better medicine.sometimes the correct medical decision is surgery.Sometimes it is medication.Sometimes it is physiotherapy.Sometimes it is monitoring.Sometimes it is a lifestyle change.And sometimes the safest decision is simply to wait and observe.A truly ethical doctor must be comfortable with all of these possibilities.The ability to perform a medical procedure does not create an obligation to perform it.
Modern medicine has extraordinary technological capabilities. Doctors can now perform operations that would have been impossible only a few decades ago. But technological capability should never become the justification for using technology unnecessarily.The question must always remain: Will this treatment genuinely help this particular patient?The answer should come before the question of revenue.Governments and healthcare regulators also have a major responsibility. If healthcare providers are rewarded primarily for the quantity of procedures they perform, policymakers should not be surprised if procedure volumes increase. The design of healthcare payment systems matters because financial incentives can influence medical behaviour.
Hospitals must remain financially sustainable. Doctors and nurses deserve fair compensation. Medical institutions require modern equipment, trained staff, emergency facilities and investment. There is absolutely nothing wrong with a hospital making a reasonable profit or maintaining financial stability.The ethical boundary is crossed when financial need becomes a reason to expose a patient to a medical procedure that the patient does not actually need.That boundary must never be blurred.A hospital’s financial health should come from providing necessary, effective and safe healthcare—not from turning unnecessary intervention into a source of additional revenue.
The medical profession has earned an extraordinary position in society because patients trust doctors with the most valuable thing they possess—their lives. That trust should never become a business opportunity.A patient lying on an operating table should never have to wonder whether the operation is being performed for the patient’s health or for the hospital’s balance sheet.The answer must always be clear.The patient’s body is not a hospital’s revenue-generating asset.An operating theatre is not a cash register.
A patient’s fear is not a business model.The success of a hospital should ultimately be measured not simply by how many procedures it performs, but by how many patients it genuinely helps.This discussion should therefore not become an attack on doctors, hospitals or the medical profession as a whole. That would be unfair and irresponsible. Instead, it should become a serious conversation about medical ethics, transparency, patient rights and the financial incentives built into healthcare.Hospitals need revenue. Doctors deserve fair compensation. Healthcare institutions must remain financially sustainable. But none of these legitimate objectives can come before medical necessity and patient safety.The most respectable hospital is not necessarily the one performing the largest number of surgeries.
It may be the hospital where a doctor has the courage and integrity to tell a patient:
“You do not need this operation.”
That sentence might mean less revenue for the hospital.But it could represent the highest form of medical ethics.Because in healthcare, sometimes the most valuable service a doctor can provide is not doing more but knowing when not to do something at all.
Disclaimer: This article and accompanying images are for informational and illustrative purposes only. Some visuals may be AI-generated or digitally enhanced and may not depict actual events or persons.Views expressed are based on publicly available information and analysis