When people are told by a doctor that they need surgery, a range of emotions can flip through their minds: Am I seriously ill? Will I be the same after the surgery? What if there are complications? According to a recent probe of a for-profit hospital chain, however, one question that patients should have been asking was: Is this surgery necessary?

While many cases of hospital negligence occur because doctors and other medical personnel don’t do enough, a recent story suggests that physicians at the country’s largest for-profit hospital chain, HCA, on several occasions performed cardiac procedures that were essentially unnecessary.

According to reports, officials at the hospitals were more interested in these procedures performed by doctors in terms of how it affected the hospitals’ profitability rather than if regulators should have been notified or if patients suffered harm as a result of the procedures.

The hospital chain says that rather than for financial reasons, the procedures were performed as a result of a focus on patient care. HCA settled with the Justice Department in 2000 over a Medicare fraud case, which involved overbilling the government program. At that time it also came to an agreement to work to avoid similar situations in the future — so if the hospital chain found itself in similar trouble again, penalties could be even more severe.

Journalists investigating the situation became aware of the allegations from a letter written by a concerned nurse to the hospital chain’s ethics officer. They also uncovered a memo from the ethics officer confirming the nurse’s allegations — and also that the nurse’s contract would not be renewed as punishment for bringing the complaints to light.

Source: The New York Times, “Hospital Chain Inquiry Cited Unnecessary Cardiac Work,” Reed Abelson and Julie Creswell, Aug. 6, 2012