From a review of The Surgeons: Life and Death in a Top Heart Center by Charles Morris:
For better or for worse, the quality of health care is driven by what Morris calls an “artisanal” value system, one that has little to do with institutional allegiances or administrative management objectives, but rather with “internalized systems of ethics and the expectations of other professionals.”
My theory of human evolution says it started with hobbies. Hobbyists became artisans. It hadn’t occurred to me that an “artisanal” value system exists but what Morris says makes sense. Such a value system should be powerful, easy to spread, and hard to eliminate.