It's my opinion that the corporate team in Dallas is pretty disconnected to the realities of the inside of a hospital. When unpopular decisions are made at the corporate level that affect the operations of the local hospital, its the local folks who are put in the line of fire having to defend those decisions ... and the corporate people are nowhere to be found to provide support. On the contrary, any request for corporate support is seen as "not being able to hold your own" or "not being strong in difficult situations."
Also, during my time there, high powered & highly compensated executives in Dallas made ludicrous "strategic" decisions that were not at all going to accomplish what they set out to accomplish. I kept waiting for someone to jump out and tell us we had been punked or something. But Ashton Kutcher never showed up.