Earlier quoted context omitted.
Would being a doctor be better in a system where there was /only/ a choice of either single payer or bring your own all-cash payment? (No 'insurance' at all.)
I don't know, to be honest. I know a lot of docs blame insurance for this, but I've worked in health policy and insurance - the problems are bigger than that. A lot of the documentation is an attempt to create "quality standards". I like that in theory, and it's independent of what kind of payment mechanism is used, but ... docs will have a riot if we're held accountable for final outcomes ("This guy has had 30 docs…
My outside knowledge is that a medical facility focuses on: diagnosis, confirmation of diagnosis, selection of treatment along with annotations about EXCEPTIONS to standard treatment, finally actual treatment. I'd like for doctors to focus more on the keen observation and decision parts and would not mind automated transcription of doctor / patient interactions to be reviewed and possibly have a summary forward (but not replacement of actual data) added by other staff. That might be an opportunity to hire/train other types of staff and gain experience in a more concrete way; much like the source article wants to make it easier for potential experts to grow in to a job.
If there's a typical outcome given an input it's important to document the decisions that affected the selection of non-generic courses of action - exceptions are things that should be known in the future. That's something that any worker should do.
The NTSB, as seen in a different recent hacker-news linked article, has excellent postmortems, even for incidents which only came close to being disastrous. A cascade of failures and lack of good decision processes seem to be the typical cause and review with recommendations on how to prevent them from occurring in the future is good. An honest mistake or poor circumstances for otherwise good people are worthy of overlooking and avoiding in the future. Lack of training can be identified and refresher courses or other supplementary training can improve the situation for everyone. Much like making sure someone is addressing problems in their job and growing to accommodate the required work.
Though there might be a bad fit for a job; either someone not able to do the expected work of an individual in that position, a job that's poorly defined and/or not broken up in to manageable units of work, or a worker that is a bad actor to some degree. All of those defects are situations that review and recommendations for remediation should address and resolve.
In your specific case, I believe having a single payer system would improve the outcome related to the above considerations. Affected individuals would still be covered by 'the system', good doctors would not be burdened by specific negative outcomes that happened to occur under their care, and bad workers of any type would be removed.
The actual outcome of individual patients shouldn't factor in to compensation. However addressing that in detail is clearly off the main topic.
I think it is both ethical and practical to recognize and classify cases that are bad fits for a given worker and to attempt to route them to someone that is a proper fit; while providing the best intermediate care and transition possible.
Also of note is that for a 'single payer' system the costs SHOULD be divorced from the actual treatment; though might be a considered criteria when a given standard of treatment is selected.