1. top most management is clueless to what is going post the middle tier
2. middle tiers - VPs/SVPs/Directors and Sr. Directors are among the worst. Mostly cast offs from Consulting firms/Tech cos/Other Healthcare firms, this group has some of the worst, clueless folks who just think very narrowly about how to get rid of problems, maybe craft a story for higher ups. Get rid of this layer ( so called people management ) and co. could shine better on the work of ICs, decent software engineers and regular rank and file.
3. Main money maker distribution is different from tech group and the IT here is almost comical - 2 years ago in 2024 there were "directors" bringing AI agents with 90% hallucination .. I mean that has got to be an industry first!