The Ouroboros, a dragon that continually consumes itself, is  a symbol for self-reference.

This piece in JAMA looks at  the persistent increase in physician self-referrals, which costs payers vast sums every year,  because of ”inadequate statutory and regulatory oversight in the face of ongoing incentives afforded by the fee-for-service reimbursement model.”

The authors say that problem requires ”regulatory or legislative relief. Support for legislative is substantial. Consensus recommendations of a broad swath of health policy experts called for the closure of ‘loopholes for in-office imaging, pathology laboratories, and radiation therapy.”’