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I've been told by more than one doctor (for chronic pain I had been having) to avoid seeing a surgeon unless absolutely necessary because they were worried the surgeon would recommend surgery even if it wasn't needed. I found it interesting. Seemed like they didn't trust their colleagues (or even they didn't trust me to make my own decision if I got the recommendation to undergo surgery).

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There's also the perverse incentives in the american medico-legal system: surgeons get sued for not performing surgery, or performing surgery badly, but they rarely get sued for performing 'unnecessary' surgery unless its completely egregious. If the patient has a history/examination which could indicate a need for surgery, and the patient has given informed consent, the surgeon is very unlikely to be succcessfully sued for operating. I'm not implying this is a consious decision on their part, rather a subconscious influence of their training, anecdotes from other surgeons etc.

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