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February 1976

"The Surgeon's Dilemma"—Continued

Author Affiliations

Cleveland Clinic 9500 Euclid Ave Cleveland, OH 44106

Arch Surg. 1976;111(2):205. doi:10.1001/archsurg.1976.01360200111026

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In the November 1975 issue of the Archives, Dr Richard Warren published a penetrating analysis of my Harper's article, "The Surgeon's Dilemma." Dr Warren refers to it, erroneously, as "The Doctor's Dilemma," but this is the only inaccuracy in his article.

Dr Warren's criticisms are four:

  1. "He [Crile] has not come to grips with the question of why a surgical fee is larger for a 'bigger' operation."

    Answer: I have never understood or attempted to explain why a "bigger" operation should command a bigger fee. I have always believed that the surgeon should be paid for the treatment of the disease rather than for the extent of mutilation that he inflicts. Only in this way can the surgeon's selection of treatment be free of conflict of interest.

  2. Dr Warren implies that Crile advocate a "leveling of salaries between specialists."

    Answer: I have never thought or written any such

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