Too many people competing for everything AND no system to check whether what they publish makes sense. Peer review only works if these doctors are not part of the same system, if they are then all of them are equally interested in covering up for themselves and for others.
If the system existed, it would actually make the expectations more realistic and make doctor's lives easier rather than increase the amount of research. But I assume the government isn't interested in the truth, i.e. realistically to fix this situation you would also need to admit that plenty of work done was basically bullshit and your numbers go down as a consequence.
If the system existed, it would actually make the expectations more realistic and make doctor's lives easier rather than increase the amount of research. But I assume the government isn't interested in the truth, i.e. realistically to fix this situation you would also need to admit that plenty of work done was basically bullshit and your numbers go down as a consequence.