> Even now, I'll take a surgeon that's a complete jerk over a nice surgeon any day, because if they've got that job even as a jerk they've got to be good at their jobs.

This seems like an incredibly poor line of reasoning.

Hospitals are often desperate for surgeons. The poorly mannered ones are often deeply unsatisfied, angry at the grueling lives they've opted into, and the hospitals can't replace them. The market is not exactly at work here.