I don't think it should have to come to that before they do something.
^^ Me neither. It doesn't, with a great doctor.
They HATE it. They would much rather I keep my mouth shut, act stupid, and just do what they say.
Again, only from the poor(er) ones. I had the pleasure under very unpleasnt circumstances, for example, to get to know a transplant surgeon who was sweet, brilliant, humble, and just a doll. He did a surgery for 5 1/2 hours and a team of 32, that should have taken 30 minutes. He chose to and was able to resuscitate a relative (he didn't play God); he would come in around the clock 24/7; he let you call him at home (and his wife was just as sweet); he would do menial things to save you from doing them like calling the pharmacy; he answered all questions honestly, including saying he didn't know (my relative was a nurse for a lifetime and worked for some of the best physicians in the world- sadly she didn't come with one to Australia, when he asked her to, lol, but I suppose I wouldn't have been born); he was just as quick to tickle the patient's feet or make jokes as he was to be 100% meticulous; he got my relative in in 2 days with a waiting list of months; his staff said he was WONDERFUL to work for ('with'), and they said they all were afraid they'd lose him to the U.S. as it was 10x the money; he agreed eventually to live in a city he hated to accomodate patients on both side of the border; he could never go more than 20 minutes outside of the city I live in for vacation since he was on call 24/7/365, and he did this all for 170K a year. (And I shouldn't have to add, but yet I do- we were not preferentially placed because of wealth, or notoriety, or afluence, or age, or anything that would distinguish her/ us as people of any position or power or influence or prestige). A few years later, I heard when the worlwide success rate was 69%, he led the world with 84%. Now that, is one hell of a person, and doctor, IMHO. It exists, but precious to find. And if you get someone like that, it is One Great Gift, no matter what the outcome.
And I think the same holds true for every profession, every great need.
ETA, but as uphill a battle this has been for you, you have been accomplishing it. And they wouldn't admit it, I think, but they are learning from you too.