Financial gain | Performing unnecessary procedures generated significant revenue well beyond standard medical practice. E.g., literature highlighted that the physician billed >$1 million for unnecessary spinal fusion surgeries. | 92.4% |
Personality disorder | Literature provided evidence of 2 or more DSM-V criteria for a diagnosis of antisocial personality disorder. E.g., physician arrested for unrelated matters, continued performing unnecessary procedures after a patient death, and showed a lack of remorse. | 48.1% |
Poor problem solving | Unnecessary procedures appeared due to poor knowledge of standards of practice or deficient clinical skills. | 11.4% |
Ambition | Unnecessary procedures appeared motivated by career ambition, e.g., to enhance stature in the field or within the institution. | 3.8% |
Mental illness | Literature mentioned diagnosis with a severe mental illness such as bipolar disorder, schizophrenia, or major depression, and this appeared to play a causal role in the unnecessary procedures. | 1.3% |
Carelessness | Evidence that unnecessary procedures occurred due to carelessness rather than intentional fraud or incompetence. | 1.3% |
Substance abuse | Substance use disorder appeared to causally contribute to the performance of unnecessary procedures, e.g., by impairing judgment or creating an increased need for cash to support addiction. | 0% |
Stress | Significant personal stress such as bankruptcy or divorce appeared to impair decision making. | 0% |
Retaliation | Unnecessary procedures appeared motivated by the perception that the system is unjust or in retaliation against an institution for causing personal harm. | 0% |
None | No motive could be identified or reasonably inferred. | 2.5% |