A doctor being accountable to a director seems like it could work in both ways. Even both ways in parallel; the director could call out some kinds of problems and cause some different kinds of problems.
The actual outcome could depend on the specific doctor and the specific director, and therefore be difficult to predict. It could even change in time, like maybe at first the directors would behave a certain way to attract more doctors, and when the customers learn that the big centers are the norm, then it would become the right time to squeeze more profit out of the system.
A doctor being accountable to a director seems like it could work in both ways. Even both ways in parallel; the director could call out some kinds of problems and cause some different kinds of problems.
The actual outcome could depend on the specific doctor and the specific director, and therefore be difficult to predict. It could even change in time, like maybe at first the directors would behave a certain way to attract more doctors, and when the customers learn that the big centers are the norm, then it would become the right time to squeeze more profit out of the system.