Would competitive specialties be competitive if everyone made the same?

[Tim]

I guess we need a definition of standing. Community and hospital. I also think this comes and goes. I used to have a large party at Christmas attended by the CEO and CMO. IS that standing? Not sure. I was personal friends with a couple of hospital VPs which helped me keep health insurance after I retired. Standing or just friendship??

Respect has many interpretations. The most valuable is respect that had been earned.
Side note, respect is not necessarily a “role model” as well as stated by a brilliant philosopher, Charles Barkley:
Charles wanted to tell parents, 'I can't be a role model for your kid. Your kid doesn't know me. I can be an athletic hero, but a role model should be a mom, a dad, an aunt, an uncle, someone the kid has contact with.“
Context as Hatton stated is important. Fame and fortune.

[Zaphod]

Correction. I think you mean the smartest minds should go into math and physics. And sometimes they go into finance but that’s a stretch to say the smartest minds go into finance over medicine as a blanket statement. I can’t prove this but I know it to be true- those in finance will have a lower IQ than physicians as a group. Even if you sample the top 5% most intelligent outliers, I also believe that it would show higher IQ in medicine vs. finance within this 5% group. Math and physics I can’t really dispute. The smartest minds should go into those fields. Whether that is the reality is debatable. But certainly if you sample the top 5% in those fields, it would undoubtedly show higher intelligence than medicine. Finance no way. Finance requires a rung seeking personality type. Finance nerds are maybe making good money but they arent making billions unless they are the top 0.0001% who created a company and happen to be brilliant.

It is not, like medicine, how many jobs do you think there are for those with the qualifications in the pure vs. finance? Tl;dr, there are more phds than academic positions.

You do not need to rung seek as a phd/trader. And why is billions your threshold for making money, especially when talking about medicine which is really capped and most phd trader types are taking home top tier physician level pay at a much younger age. We're not talking analysts here, who still can make mid 6 figures by late 20s.

As for IQ, given finance is a very broad field with tons of people and less selective than medicine, 100% thats likely the case. For the top 5% I would bet 100% against it, since you're talking some of the smartest math/phsics PhD people in the world, the Simons, thorpes, etc...you cant throw a pen without hitting a rocket scientist.

[Panscan]

eh, i don't know.

i definitely grew up in a smaller town where there was a subset of doctors who everyone knew and respected. they had a lot of clout. that's still true at most hospitals. if you (WCI) want to leave your CMO isn't even going to know unless you happen to be friends or you're on a committee. if that spine surgeon is trying to leave it's going to be known and there are very likely going to be convos about possible retention. i know at least 2 rainmaker docs (both surgeons) who work in medium sized communities in private practice and they only talk to the CEO of the health system when they have issues.

even now i know people who are very high profile doctors in their community. it's still a thing. and there are plenty of docs who enjoy that and i don't pathologize it. my FIL is a pretty well known doc in his town and the town is slap full of people who will come hug him in the grocery store.

True regarding the high income generators and their associated influence but those are what 5-10% of the staff? Basically just surgical and medical specialists that bring in the big bucks for the systems. Rest of the people just moving meat. Outside of those I think everyone standing pretty similar.

[Zaphod]

There is a decent amount of medicine that is merely toiling- doing something for the sake of doing something. Some actions driven by patients, some by physicians, some by malpractice.

It's how APPs can get similar outcomes to alot of problems with less knowledge. The human body can tolerate a lot (but not everything). (To add: I don't think APPs have the same level of knowledge or critical thinking skills, and the ones that are good have been working closely with a physician who has appropriately trained them to be an extension of the physician).

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Few

[AR]

Correction. I think you mean the smartest minds should go into math and physics. And sometimes they go into finance but that’s a stretch to say the smartest minds go into finance over medicine as a blanket statement. I can’t prove this but I know it to be true- those in finance will have a lower IQ than physicians as a group. Even if you sample the top 5% most intelligent outliers, I also believe that it would show higher IQ in medicine vs. finance within this 5% group. Math and physics I can’t really dispute. The smartest minds should go into those fields. Whether that is the reality is debatable. But certainly if you sample the top 5% in those fields, it would undoubtedly show higher intelligence than medicine. Finance no way. Finance requires a rung seeking personality type. Finance nerds are maybe making good money but they arent making billions unless they are the top 0.0001% who created a company and happen to be brilliant.

I kind of agree with this, but I think when people say "finance" in this context, they're not talking about the branch manager at your local credit union, which is most definitely finance. Finance is so broad, that just carving out the top 5% is not enough. Maybe top 0.5% and then you get a meaningful comparision.

There are a good number of top level math guys who just decided that finance was more lucrative than professional math. So, that's is what they do. So I guess when I say finance, it's the type of finance career path that a decent Math PhD would have access to. Which is a very small slice of the "finance" unverse.

[Hatton]

Sorry to burst your bubble, those docs aren't more "highly respected", they're more "highly compensated", and it's the money they bring in, not their "standing", that the hospital would lament losing.

As for recognition in the community, I'm also in a semi-small town hospital and the docs who are most loved in the grocery store are 1. Dr T, the orthopedist who has done everyone's knees for forty years, and 2. All the family docs and OBs who have delivered everyone's babies for forty years, and 3. The PCPs who have seen everybody, their kids, and their kids' kids for three generations. Seems to have nothing to do with money or standing, but with human relationships. And to my mind, that's how it should be.

Very much agree that community standing comes from long term personal relationships.