Carrol Cox:
> There is a contradiction that might operate [pun] under socialism
> (or any regime) as well as under current capitalism. The survival
> rate of surgical patients in a hospital is in more or less direct
> proportion to the number of that type of surgery performed in
> a given hospital. The reasons for this bear out Gar's argument
> that "there are quite a few other types work which save
> lives within the medical profession," but in an uncomfortable
> way. The more times a surgical team performs an operation,
> the higher its success ratio. This means that one has to choose
> between (a) overworked medical teams or (b) lower rate
> of survival of patients.
>
> There are ways to get around the production of elites insofar
> as that 'production' has political or economic roots (differences
> in education, etc.). But when it is sheer quantity of practice
> that creates an elite, *that* is hard to get around.
In the case of medical teams (and others) the case may be more complex than one of simple aggregate practice time. For instance, some teams may be selected for further practice on the basis of past success. That, in turn, may depend on the ability to select the best cases. And some teams may have more political power than others, and thus be able to command more and better resources. I don't know enough about medical practice to say more, but these effects are certainly noticed in other forms of production.