How does this fit with the man who puts patient well-being first,

house does not put patient well-being first. he puts the diagnosis first. patients are basically incidental to him, as evidenced by (a) his lack of interaction with them and (b) his willingness to put them through dangerous, painful, potentially deadly, and usually unnecessary procedures and/or treatments.

the argument that the show has always put forth, and that the character has voiced several times, is that he can solve the cases other doctors can't precisely because he's not concerned with the patients.