Docs here have a job with competitive pay, benefits, and few thousand dollar CME reimbursement. Your role is necessary, to help push patients through; the nurses need someone to call, whenever something comes up - any little thing.  You get feedback on your performance, particularly regarding “productivity” and if someone complains. You are frequently reminded of your importance, yet you don’t feel very important - you’re being told what to do essentially.  Your director is hospital-employed; he/she is in the similar position you’re in; he understands your concerns and is apologetic he’s not able to fight for you, in any way. Your nurses have more established and supportive advocacy.  Your work spaces are getting smaller & more crowded. Non-Physicians are increasingly in physicians’ spaces; you are considered their leader, however you’re not in charge of hiring, reviewing, or substituting one for another. Furthermore, they can complain about you and get you into trouble, so you have learned to approach daily work in a more ambivalent manner. You know something’s gotta change, but you don’t see anything changing, nor can you, from your vantage-point see what will influence desirable change. So, you just suck it up, and thank God you’re employed and your bills are paid & lights are on... And you think about how long you’ll need to live like this...