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It is pretty difficult to imagine what a thing you cannot comprehend is like, and Lem does an outstanding (though still imperfect) job.
If you haven't read this book give it a shot.
They probably made this up....
BTW, if you think that "real engineers" deliver on time with predictable results, you need to read more about real engineers.
Perhaps you are confusing the cause and the effect?
There is a reason for this. If you live rural, there is no backup. It comes down to your ability to handle doing surgery at 3 am effectively even though you haven't been home yet. Sure, you aren't as good as when fresh.
Perhaps the problem is that there is no backup. There should be more than one doctor available. We are just not willing to pay for it.
Working 90 hours a week is work hoarding. There are other people who could be doing this work and most likely better...