There are a lot of different motivations within the medical system. To jump off of your bypass example, people who get a bypass typically are on medication for the rest of their life. This motivates a subgroup of doctors to save these patients. There are good doctors and good groups. In a field with a lot of bad apples, the good ones tend to congregation in certain areas and specialties. I had a neighbor who who traveled a lot for work. He got real bad food poisoning but didn't have the usual cramps, puking, or diarrhea. However, he felt he was going to die and went to the closest doc he could drive to based on google maps. He ended up at a small clinic in a tiny town in Nebraska. The only doc on staff there helped him out and a nurse drove him to a hotel room for the night. When he came back the next day feeling better he ended up talking about other issues he was having with arthritis like issue in his hands and psoriasis. The doc gave him a bunch of recommendations like taking an allergy test and how to taper off of the meds he was using at the time. He kept in contact with the doc and within about a year of following his advice he was off all meds and feeling like he was 20 years old again. It's crazy to think this random happening basically turned around my neighbors health. There is a lot of sophisticated medicine out there, but it's been so thoroughly corrupted that almost no one has access to it. This is the reason why people like Cheney, Soros, and other very rich people can live to 100, but guys in my neighborhood with no bad habits are suffering in the early 50s.