That's why I used the PCP as an example, most people start with a PCP, and though the doctors he refers out to may want to do a procedure to maximize their RVU's, the PCP gets no incentive for referring out that patient (and anti-kickback regulations prohibit that kind of compensation even if the PCP and specialist are in the same practice). So the PCP helps keep this in check.

Even ignoring RVU's, most specialists will want to treat a problem with their speciality if it would be an effective treatment so a second opinion is almost always a good idea. I shopped around for treatment for a procedure I needed, the robotic surgeon recommended robotic surgery, the laser specialist recommended laser surgery, the general internal medicine doctor gave a few less invasive alternatives. I researched them all, went back to my PCP and picked the procedure I wanted to have done.