An article in the Stlouistoday.com that can be found with a google search : surgery is for your needs, not your doctor's" , talks about how a few unethical doctors practice assembly line medicine to line their pockets. In my experience it is rare. Most doctors are good caring individuals but there are hacks out there. In the top institutions, this is rare. In the second tier facilities many struggle to stay in business.
When you are referred to someone ask hard questions. Do your homework. If you don't like what you are told or what you find out about your St. Louis metropolitan area physician, run!