Even slime mold organisms know they must self-organize in times of stress. Physicians were too affluent and complacent to bother. Now they are mostly employees of hospitals and therefore units of production for profit maximizing institutions. They generally make plenty of money and work fewer hours under this arrangement.
The patient moves away from the status of vauled slave and moves closer and closer to being that virtually inanimate object of efficient production so cherished by the Toyota Production System. Efficiency and profit supercede effectiveness--which is seldom measured. Measures of effectiveness would necessarily involve the patients point of view. It is easier to measure throughput, cost, and profit and leave the messiness of patient perspectives out of it.