That would appear to be the question.
My doctor nephew had some time off over Christmas. He will be doing New Year instead - in the emergency department of whichever hospital needs him most.
Currently he is doing enough "doctoring" to cover his living expenses and doing some research as well. It is the sort of research which should be funded by government but it won't be. It has major implications for eye surgery and saving sight. It isn't 9am-5pm research. It is 8am-10/11pm research - on one day just before Christmas he finished at 1am. He was back in the lab at just before 8am.
He tells me he isn't the only one. I know he isn't. I probably understand a bit more than the average individual does about what he is doing and why he is doing it. I also understand some of what drives him to do it. I have also been driven by the same sort of passion to get something done.
But he gets frustrated, as do the people he works with, at the amount of time that has to be spent convincing administrators that the work is worth doing. He faces a similar situation when he is doing work in the emergency department. Does he admit a patient? Does he send the patient home? Does he go on his "gut instinct" and treat the patient or does he order a test because "something else doesn't seem quite right"?
He makes life and death decisions. His colleagues make life and death decisions. They make those against a background of administrators who are trying to dictate that they do one thing or another, that they "save money" and that they never make mistakes because of the risk of litigation.
I understand a little of this - only a little. There have been times when I have been asked to provide communication assistance in an emergency situation. I am under pressure then. I can't make mistakes then because somebody's life may depend on asking the right questions in a way which can be understood and then getting answers they can understand.
But I don't do it all the time I am at work. I often have time to go back and check my work - often double check. I know that the doctor or other person at the other end is relying on me to be accurate and to do my job without a fuss. I am not there to question what they want or how they do their job. I might be able to say, "I did this for X once before. Do you want it done the same way or have you got any particular requirements?" I don't say, "You have to do it like this."
So this morning when I see that, once again, the paper has a piece about there being three times as many administrators as doctors in our hospital system I can only feel for the doctors. Would it be possible to just let them get on with the job? They know more about medicine than I do.