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PaperclipPerfector  5d ago (text post)   24076 thread views

Culture War Roundup for the week of November 18, 2024

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Instead of allowing (as engineers, bankers, and lawyers do) a big gradation of physicians, all of whom can call themselves the prestige title doctor but who vary widely in terms of competence, pay, and reputation in the profession

To what exactly are you referring here? As another commenter has pointed out, there are no official gradations of "licensed lawyer": all people who obtain a lawyer license are officially lumped together in a single group, though they are required (1 2) under their ethics code to refrain from actually practicing outside their respective areas of competence. The same is true (ยง II.2) of licensed engineers, and the National Society of Professional Engineers is explicitly opposed to divvying up engineer licenses as you suggest has already been done. And I don't think there's such a thing as a "licensed banker".

I don't understand your confusion. She says it right in the part you quoted. Instead of allowing physicians to have varying levels of competence to go with their shared license/title (like other professions do!), they overregulate quality by strangling supply of practitioners.

That there are no official gradations of "licensed lawyer" is her point. MDs don't need different licenses; just allow more variability among the licensed.

Licensing is one thing, but self-selection signaling is another.

If I graduate from the American Samoa school of Law (that's a Better Call Saul reference) I can handle wills and whatnot, but no real going business concern is going to hire me for complex corporate litigation. If I, this hypothetical business owner, enjoy spending my weekends enjoying recreational Columbia narcotics, I'm going to hire the lawyer who is ex-DA's office and knows all the judges, instead of the one man libertarian law firm who will passionately argue about decriminalizing all drugs.

Basically, we're talking about signaling-credentialism. If a Lawyer went to Yale Law and now works at Latham & Watkins, he or she is probably quite good. If a banker went to Harvard and is now at Goldman Sachs, likewise*. For doctors, we don't quite have the same gradations. If you're an attending in any major metro hospital, you're roughly interchangeable outside of specialties.

I think what OP is saying is he'd like to see more doctors, even those who are the equivalents of Saul Goodman - they can write a prescription for some antibiotics, but you're not going to them for your hip replacement. I could be wrong tho (not op)

  • They're good in the way that matters for these specific professions (law, banking) - they know the right people in the right places. Many of them are probably good at, you know, lawyerin' and finance and whatnot, but 80% of these jobs boil down to "yeah, I know that guy."

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