I don't doubt that many doctors aren't fit for duty and, just like the Blue Wall, they have their own code of silence. Just like IT folk, too. I could tell you toe-curling tales of IT incompetence with mission-critical systems, such as banks. If you don't think a bank's trades processing system has real-world consequences, then I don't know what to say.
As for teams and teamwork ... it sounds like you're too jaded. Yes, a team can be used to squelch initiative. It can also be used to build said initiative. And, many times, the person with the initiative would have screwed the pooch and it was only due to the team keeping a lid on the loose cannon that the mission-critical system was saved. I know - I've been that loose cannon.
The key is to encourage creativity and initiative while still maintaining alignment across all team members so that everyone is going in the same direction. Remember - you are paid for a reason. If you don't like it, make your own company.
My criteria for good software:
- Does it work?
- Can someone else come in, make a change, and be reasonably certain no bugs were introduced?