One reason for practice variation

Patient demand, and we all know that medicine is now a customer-service business:

Sometimes, demand is fueled by patients.

Patients with back pain often want surgery, says Thomas Sweeney II, a surgeon at the Southeastern Spine Center and Research Institute in Sarasota, Fla., a city where fusion surgeries among Medicare patients are performed at a rate higher than the national average, according to data gathered by Dartmouth researchers.

“Here in Sarasota, patients want to play golf and tennis, and they’re in their 80s,” Sweeney says. “There’s a huge demand to be able to do what they want to do.”