In healthcare financial management revenue is driven by discharges whereas expense is everywhere. Do not confuse being at the game with playing it. Thirty years experience or one year's experience thirty times. Not all actions evoke responses and some costs are not subject to activity. How fixed some costs are is directly influenced by the fixation of the manager.
Attention breeds success.
At best what we have is a temporary lease. Recognition that each hospital activity is a potential franchise is important from a cost control standpoint. Function vs. Responsibility. A leader can tell the difference. Good news properly communicated will travel as fast as bad news that is not communicated at all.