The thing is they types of physicians that become leaders at hospitals aren't the same ones who are in it "for the medicine". They're essentially MBA types with a medical degree. Many of them are largely removed from day-to-day medicine.

I don't really mean this as a dig at them either. It's just the way of business. High level leadership takes a certain type of person to survive and thrive. This tends to be people who want to optimize the value of every hour they spend working.