> I would caution against characterizing medical training
> solely in these terms. I won't deny that there are aspects of
> the training process that fit the above. But it's not just a
> matter of ensuring dominance by a small group.
Of course not -- skills and knowledge are conveyed. But it is onerous as hazing, not to teach.
> Remember, this "small group" is created by the training
> process. It requires years of study of anatomy and
> physiology, hands-on experience, and a wide range of other
> disciplines (say, the design of experiments, the rigors of
> diagnosis, use of certain technologies, etc.) One could say
> that this is exclusive only to those who can afford it (or
> who can line up grants and funding), but the point is that
> the people who are allowed into this "small group" _must_
> pass through this training process.
They must pass through training -- not the process we have...but this is not particularly critical to the issue at hand, which was incentives, pay, etc.
> This is, after all, an area of work in which the risks are
> fairly high; we are talking about the health and well-being
> of humans. And it seems to me that a decent and humane
> society would work to ensure that those who practice medicine
> do so with a proper standard of training and ethics.
Of course, which would entail, I suspect, a much better and richer training process than we now have...witness the extent to which our current health system is perverted to profit...
> (Frankly, a society that'd allow frauds and quacks to operate
> strikes me as being criminally negligent-- it'd be like
> letting carny barkers run the stock market. (Oh, wait. They
> do.))
Yes, but this is our society, not parecon...of course.
> It'd be great if most people could be given a far
> greater understanding of what modern medicine is. But this
> is one of those cases where an "elite" is more or less required.
In every area, people who do the thing will no more about the thing than those who don't. That isn't what makes an elite. What makes an elite is that it has power and privilege that is not warranted and is guarded, etc. That won't exist in a parecon -- though of course there will be people who do surgery, etc., with the best possible training, etc.