A Patient Who Wanted a Second Opinion
Not long ago, a patient walked into my clinic seeking a second opinion. His story was simple but telling: a private surgeon had recommended surgery for his degenerative meniscus tear, and he wasn’t sure if it was necessary.
This single case sparked a much deeper conversation with a third-year medical student who was shadowing me. I asked for his thoughts on the difference between private and restructured (public) hospitals, and whether he’d encountered anything similar.
What the Student Already Knew
The student surprised me. Before medical school, he had shadowed an orthopaedic surgeon in a private hospital. That surgeon candidly told him, “Profits come into big play in how we prescribe surgery.”
Imagine hearing that before even starting medical school. For someone hoping to devote his life to helping patients, it’s sobering. But the student simply said, “I already knew this.”
His calm response was striking, and it made me reflect on my own observations. I agreed: there is plenty of data showing that certain surgeries are more common in private than in public hospitals.
Evidence in Plain Sight
Take caesarean sections. Across countries—from Australia to the Netherlands to Singapore—rates are consistently higher in private hospitals. The hypothesis is clear: a caesarean earns more than a vaginal delivery, so the threshold to operate is lower.
This is not unique to obstetrics. In orthopaedics, we see similar patterns. Some procedures are offered more readily in private settings. It would be naïve to think otherwise.
It’s Not About Public vs. Private
Yet the point is not to demonize private healthcare. I personally know surgeons in private hospitals who make purely evidence-based decisions. I also know surgeons in restructured hospitals who might, consciously or not, let personal gain or the desire to practice a procedure influence their choices.
The uncomfortable truth is that the dividing line isn’t institutional. It’s personal.
The real boundary between good and evil runs through every human heart.
Safeguards—But Not Perfection
Public hospitals do try to curb these tendencies. We have audits: cases are presented and scrutinized by peers. Salaries are less tightly tied to surgical volume. These reduce financial pressure—but they don’t remove it entirely.
At the end of the day, a surgeon can still justify almost any operation by saying, “The patient wanted it,” or “It might help.” No system can fully police the human heart.
Where the Gospel Speaks
So where does this leave us as Christian doctors? The Bible calls anything we put above God an idol. If money is our idol, profit will quietly steer our choices. If skill and reputation are our idols, we may chase the most complex surgeries just to boast of our prowess.
The gospel frees us from these idols.
- God sees everything. He knows when a decision is motivated by greed or pride.
- We all fall short. No surgeon can claim perfectly pure motives.
- Christ paid for our failures. Because Jesus bore our guilt, we can repent, receive grace, and face the next patient with a renewed heart.
Every consultation becomes a fresh chance to put God—not profit, not pride—at the center of our decisions.
Conclusion
Medicine will always be an ethical challenge. No audit system or salary structure can fully safeguard patient care. The deeper safeguard is spiritual: remembering that God is watching, confessing where we fall, and relying on Jesus to help us choose what truly serves our patients.