The selection process for doctors often creates some rather perverse outcomes. Medical schools are hyper competitive, and incredibly demanding. The most typical motives a person might have for enduring those demands are some combination of money, prestige, and the ability to do the rewarding work of helping people. So doctors basically have to be hyper competitive, able to endure incredibly demanding workloads, and could potentially be motivated by some combination or money, prestige and a desire to help people. But there’s no test for the altruistic motives in med school, and competitiveness tends to be more associated with seeking status than altruism, so med schools tends to serve as a selection mechanism for these more shallow personality characteristics. At the very least the common assumption that doctors have an innate passion for serving their patients is not valid. Even if it’s true that most doctors want to help their patients, it’s not necessarily true that their reason for doing so is aligned with the best interests of the patient.