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May 2, 1990

Preoperative Banditry: Surgeons React-Reply

JAMA. 1990;263(17):2301. doi:10.1001/jama.1990.03440170022023

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In Reply.—  Indeed, we did encourage my father to look elsewhere for treatment. Contrary to popular belief, however, patients are not always empowered consumers: they come bare and disenfranchised by pain, fear, finances, and geographic constraints. My father spent his psychic allowance deciding to have surgery. And because of his financial situation, he needed to choose a physician whose practice was close enough to allow my mother to continue working.Four years ago my husband and I also had no choice of physicians when our daughter—4 months premature—was whisked to a tertiary care center 45 miles from our home. In contrast to my father's experience, our daughter's physicians made it clear that our financial status would not affect her treatment. Even after discharge, as her bills neared the $1 million insurance limit, our pediatrician offered to continue treating her without coverage. Similarly, we had no choice of physicians several weeks