Mandated continuing education isn't a sign of missing incentives, it is the incentive. Being required to do something to keep working in the field seems like a pretty strong incentive to me.
But I certainly won't dispute that doctors in most systems in the US are overworked starting at least in residency.
We both know there is a difference between intrinsic and extrinsic incentives. This difference underlies so many things, including: (i) justification for regulatory frameworks; (ii) individual motivation; and (iii) likelihood of follow-up / compliance.
But I certainly won't dispute that doctors in most systems in the US are overworked starting at least in residency.