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On your last point: I think it's useful to think in multipliers and desired outcomes.

Do you want the best doctors involved in care for patients and training juniors, or do you want them to spend time jockeying for a position in the hierarchy because that's a plausible but also the only way to 2x their income?

This doesn't fully answer the question, of course, but it suggests that large pay disparities are extremely wasteful for society as a whole.



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