In most companies, "operations" staff is among their lowest-paid: customer service, cashiers, bank tellers, factory workers, etc. They are used to constant adherence to strict metrics.

Medical care is strange in that the operational staff includes doctors, who will bristle at their expertise and years of schooling culminating into being judged on how many reviews (or appointments) they can churn through.

It's an interesting issue that I sense naturally causes this kind of conflict.