But what do you optimize for during training? Patient health sounds subjective and frankly boring. A better ground truth would be patient lifetime payments to the insurance company. That would indicate the patient is so happy with the surgery they want to come back for more! And let’s face it, ”one time surgeries” is just a rigid and dated way of looking at the business model of medicine. In the future, you need to think of surgery as a part of a greater whole, like a ”just barely staying alive tiered subscription plan”.