Lack of empathy of managers and Keplr leadership. Lack of understanding from corporate office and higher leadership how their processes impact those outside the corporate office the ones who they expect to follow their requirements a d who they need to successfully reach goals and implement change. They have zero clue or they frankly don’t care how things impact the people (not numbers or statistics) that did not choose to work for them but were acquired. They say they do not micromanage but their whole system and setup in every aspect of the practice is micromanagement. They have to control and be involved in every step, even if It makes the process unnecessarily tedious or longer. They become the middle men because they need the control, like they forget the practice was successful before them and they should focus their resources and attention not on micromanaging and having control of every little thing but on how to improve innovation, technology, staff morale and support, and quality of care. Instead of paying corporate employees to do a job that they practice has employees for, pay your people better. Improve your benefits. Improve your technology and the preferred partners to ones that are more advanced and cutting edge. The doctor and clinic are key but without the rest of the practice and employees the doctors cannot do their job and the clinic fails. Being cutting edge applies to more than just clinical equipment and partnerships.