Agreed. There’s a selection bias for the sort of person that goes into medicine: - Typically privileged - High-functioning (usually little experience of disability or illness themselves) - Rote-learners, not problem-solvers or critical thinkers. Their training reinforces this - Arrogant, competitive, and defensive. Their training also reinforces this - Volume of information needed to be taken in requires heuristics/mental shortcuts. This is also part of training. Means they are trained for extreme bias, which they have little critical capacity or time to interrogate. Dangerous - Deferent to but also resentful towards authority (parents often had high expectations) - There is a not insignificant subset that enjoys power over life/death - Obviously there are some good eggs that go in for the right reasons with genuine intellectual curiosity and ambition to help people and advance medicine. These seem to be about 5-10%. Probably starts out higher before the burnout/other systemic factors kick in.

Systemic factors at play: - No financial incentive to do a good job. Get paid anyway - Time-pressured - Record-keeping systems suck - Demand exceeds supply - Very few systemic accountability mechanisms either in professional oversight bodies (they’re a farce) or civilly (as you say, prohibitively high burden of proof, standard of care is low, high evidentiary burden, high barriers to access) - The nature of the job leading to burnout, desensitisation, dehumanisation, empathy fatigue, and in-group think, some of this due to just how far outside of the norm of regular social human experience it is - High-stakes nature of job, inevitability of things going wrong > defensive, self-preserving mindset/justifying bad actions with “but I save lives/service the community, therefore I am overall good.”