A hierarchy is a structure of group members arranged in order of importance or according to their skills and responsibilities. The development of the hierarchies in today's hospitality industry can be traced back to the introduction and evolution of sophisticated cooking brought into France from Italy during the Renaissance. In the dining room proper, the maitre d'hotel supervises customer service, the sommelier proposes and serves the wine, and your waiter looks after your table. You, the client, become the focus of their attention, usually combined with a friendly smile. They are trained to spoil you.
Similar hierarchies exist in good hotels and small airlines.
In hospitals, hierarchies are slightly different. The head administrator is at the top, followed by the chief doctor, the head nurse, the porter, the rest of the doctors, the nursing and paraclinical staff, and the janitors. At least, this is my impression, based on the experience of sick family and friends in different European countries. Many people with whom I have talked over the past few years share this view. Patients are often considered a nuisance.