The Toss-up

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Abstract
Considerable turmoil is often created when expert physicians have different and strongly held opinions about the optimal treatment strategy for a given patient. Indeed, opinions may be widely discrepant: one clinician may recommend a risky surgical procedure, and the other may favor medical therapy; one may propose an invasive diagnostic test, and the other may dismiss the test as unnecessary and insist that the patient be treated without delay. Paradoxically, sometimes a surgeon advocates medical therapy while the internist recommends surgery. How do we explain these striking contrasts? Are some physicians naturally attracted to more aggressive treatments? Do some require . . .