When talking to physicians about practice variation, “Why does hospital A have higher cesarean rates than Hospital B?” is likely to be more effective than “Why does Doctor A have higher cesarean rates than Doctor B?”
Nonmaleficence must not be sacrificed in the name of the patient’s autonomy, but there is no need to undertake needlessly invasive treatments for a small boost in protection against cancer recurrence if the patient does not wish to do so.
It is an understandable human reaction to feel defensive in the face of evidence that challenges one's practices, but it is imperative that we rise above this with a modicum of humility and ask the tough questions: what causes problems and how can we avoid them in the future?