Sridhar Vembu’s Blog

I attended a short presentation on the book “No Asshole Rule” by Professor Robert Sutton. I have personally followed something similar to that rule.I believe anyone can be effective in their job, and be effective leaders without being assholes. One thing Professor Sutton mentioned was that the pervalence of assholes in the workplace was high in professions like medicine (arrogant doctors abusing nurses and other lesser breeds) and law (rainmaking partners abusing associates, paralegals and so on). It struck me how these are exactly the two professions where you need formal, state-sanctioned credentials to practice. Just about anyone can enter the software industry, and just about anyone can be the CEO of a public corporation - no formal credentials required. But even very experienced nurses, who are perfectly qualified to dispense medical advice, are prohibited from the practice of medicine. Of course, in practice, nurses do write prescriptions in the doctor’s name, but by law, they are told to be a lower caste needing the doctor’s name to sanctify what they are perfectly capable of doing themselves. All that the licensing laws have achieved is to create a state-sanctioned priesthood, and the inevitable caste hierarchy within these organizations.

Milton Friedman explained in the book Capitalism and Freedom how abolishing licensing/credentialing laws will improve medical care while lowering prices. The whole argument about unqualified quacks harming people is a redherring designed to keep the priesthood in power. In practice, chains and brands will emerge offering low cost, affordable medical care, and since they would have a reputation to protect, they will do the quality control on medical care.