There is a thing called "best practices" in medicine. Surgery is never the first option if any other option is available. Doing it any other way would be, in your own words, "playing games". I know quite a bit about this. I hear about it every day. My wife is a long time malpractice claims adjuster representing half the hospitals and doctors in the state of Louisiana. Performing surgery without first eliminating other less invasive options would open up a can of malpractice worms. That is a fact.