..but I understand his broader point - these are not deeply introspective, gifted individuals. A front line GP (and probably many 'specialists') is an auto mechanic who replaces an awful lot of ECM modules unnecessarily along to way to actually fixing the problem. In an aggressively supervised service field many of these people wouldn't make it. Doctors may get flagged when they kill enough people over a local threshold, but qualitatively dismal performance (empathy, followup, even a solid fundamental knowledge of the subject matter) is tolerated quite nicely in the system.

I wasn't kidding. The management aspect of the medical system is terrible. The quality standards of individual procedures is high but the overall management is terrible. Nobody talks to each other, everybody just does their little part without anybody having a bigger picture. My girlfriend now has had several failed surgeries. Whenever we go to a different surgeon they never ask the previous guy what he has done. I once suggested he should call and ask. The surgeon seemed really insulted. And as I said before when something fails there is no retrospective. They disappear and send a 50000 dollar invoice.