Or... the third doctor has recently completed his internship and is eager to start his own practice. Because he lacks the experience of the other two he does not understand the costs of running a successful business while generating a profit. During the course of the operation he realizes it is taking too long and reducing his profit. Therefore he takes short cuts to reduce time, reducing survivability.
Something of that nature occurred with JR radios about a year ago. In the quest for ever increasing profit margins the company was leveraged to move manufacturing to new and cheaper “foreign” suppliers. In decreasing manufacturing costs quality suffered, to the point the parent brand name announced it could no longer assure the quality levels it once provided.
A combination of market forces impact product quality. Consumers gravitate to the lowest prices, causing manufacturers to reduce selling prices which in turn reduces margin. As there’s always someone that will undercut selling prices further other manufacturers need to find a way to reduce their prices in order to continue selling product. There comes a point sacrifices have to be made, either in margin or quality, for older manufacturers to remain in business.
Labor costs are usually the first impacted, with wage cuts or wage freezes. Experienced workers become unhappy and leave through attrition or lay offs, to be replaced by inexperienced cheaper labor. Component costs follow and the only way to reduce components costs is through high quantity purchases or obtaining lower quality, lower priced components. Sales projections establish the number of units to be manufactured, which in turn determines how many components will be needed. If that number is relatively low it limits the number of components ordered, reducing quantity discounts. So cheaper, lower quality components are obtained.
The competition process is also significantly impacted when many of the products manufactured are made in a country where the government subsidizes at levels that allow the businesses to operate at a loss while showing a false profit from government provided funding. Their economy has the appearance of growing at a much greater rate than other economies but the truth is that growth is mostly government subsidization debt. Manufacturers in other countries that are not being subsidized cannot compete and turn a profit so in order to survive they relocate their manufacturing facilities, and jobs, to the country where the government is subsidizing “private” manufacturing. Therein lies the foundation for trade wars, tariffs, and embargoes.
Subsidize long enough and competing businesses outside the county eventually close their doors, eliminating jobs and incomes, leaving the one country as the only place left with the facilities to continue providing products. It’s also one of the reasons illegal immigration is not prevented here. Illegal immigration is another form of “outsourcing” to obtain cheap labor but instead of moving companies to their locations the labor comes to you. A constant source of cheap labor inhibits wage growth with the legal population, which maintains higher profit margins for the employers of illegal labor. As big business controls “free” governments there’s no impetus to control illegal immigration.