That's down to the (obvious) fact that job performance and working ethics is not equal but distributed among practitioners.
I think this is especially visible in software "engineering" with people joining the craft after a few weeks of boot camp. (think engineering vs programming)
However, we put doctors through an especially rigorous and long training and certification process to minimize the amount of unqualified practitioners.
I've encountered a few people who were doing something very close to this. I really hope that doesn't happen in medicine too.