Slow motion train wreck
If MedicalDirector is the Titanic then the people at the top are the band who just keep pretending nothing is wrong as the ship goes down. The biggest question is where the owners are whilst all this is happening. How do they not see promises (generally being inflated by finance who then beat people with them when they aren't met!) continually being made but then never delivered on?
People being continually let go as targets are not met and funds dwindle, good people leaving as they see the writing on the wall, restructure after restructure dressed up as "strategic realignments", a flagship product, badly built and not fit-for-purpose and no plan for how to dig out of this mess. The common denominators are those leading this show but they remain in their cushy positions regardless.
Owners, have some nuts and do something rather than seeing things go further down the toilet.
There are some really good people, the stated vision makes sense
Instability, no ability to deliver on stated vision, cracks continually papered over, high attrition...I could go on