Mainly for mlw, but I've likened it somewhat to working in a coroner system vs an ME system. In those scenarios while the finances aren't much different, the autonomy, expectations, ancillary services, and ability to affect and improve the working conditions and overall quality generally are. Still, some people definitely prefer that ability to throw problems off to the revolving coroner, and simply do their work and go home. But, many doctors just don't have that mindset -- they recognize a problem, are bothered by it, and would like to see it improved/fixed. Some things of course we recognize we just can't readily fix, but that's different from a non-medical admin/MBA/coroner/whatever simply not caring about what you find important, or even actively making your job more difficult in order to further their own separate aims, whether they be political or financial or whatever.
A fair point was raised about academics, but I think people join an academic department with a better understanding of the trade-offs. After all, most pathologists spent 4-6 years of training in one or more academic departments. The pace is usually a little slower particularly if there is a residency program, there is a little more freedom to work up cases with wild abandon, there are usually a few very knowledgeable and experienced pathologists around who are usually more available for hallway consults, ancillary resources are usually a little more available, there is usually a little more time built in for other pursuits (even if a lot of it happens to be spent on catching up, that's time not spent after hours at work at the scope), etc., and there is more of a sense that you're subsidizing a pertinent institution, including your own department, rather than simply the pockets of a few bungholes solely interested in "your" money.
