I’ve been told that Centers of Excellence like Mayo and Northwestern Medicine in Chicago where I receive treatment indeed pay fair salaries to physicians so they don’t have to sell their services to earn their keep. For my first go-round of prostate cancer, I went to a local community health system that I now recognize as having second class care. As I understand it and I could be wrong on this, urologists that performed radiation therapy or surgery were incentivized financially when they did those procedures. My initial urologist specialized in robotic surgery so that’s what he recommended. The second urologist specialized in brachytherapy and EBRT so that’s what he recommended. The team approach did not exist them, and to the best of my knowledge does not exist there now. Each of them trash talked the other’s procedures leaving me feel like I was the monkey in the middle. I believe financial considerations often came before patient care, which is why I now appreciate the differences in the comprehensive care that Mayo, Northwestern provide.