When company changed to Included Health emphasis changed rapidly to money driven company. You have to provide everything that patient want doesn't matter how wrong/ unethical /even risky it can be. Patient - in this case customer is paying and so has right to get everything and evaluate provider for anything. Simply if you will not give patient what you want you will be evaluated low by patient and punished by management. Providers salary is linked to patient satisfaction. In direct way patient is aware that he/she/it can punish provider any time and provider is force to give them what they want. That makes any customer the physician without going to medical school/residency/practice.