A well-performed operation is still malpractice (or even assault) if it is not done for valid medical reasons. Operating for marginal (or less) reasons is more common than most of the public realizes — after all, surgeons are paid (quite well) to operate, and they rightly take pride in operating with skill. To be paid handsomely for what you love to do is a privilege, a joy, and a very dangerous temptation. Not every patient who consults a surgeon really needs surgery — often, non-surgical treatment is more effective and less risky.

Thus, when I quiz my students and residents about treatment options for various conditions, I always insist that they begin with a discussion of non-surgical treatments. Honest and conscientious surgeons only do surgery when less invasive options are inadequate and there are clear, justified reasons for surgery. The patient’s health, not the surgeon’s ego, is paramount. This is basic surgical ethics.