I really don't understand how this does not create an endless stream of problems (or, quite likely, it does, but they are well hidden). But keep in mind that the power of hospital administrators is severely restricted compared to software development managers (what is really reasonable, by the way).
It's a general rule for all kinds of engineering that one can not deliver quality if the management isn't composed of good engineers. You can deliver all kinds of stuff, but not quality.
imagine management asking surgeons to cut corners and water down disinfectants, the lawsuit would be _legendary_
How did we get this bad? Is it our education? Computer science isn't really even science let alone engineering. It's more like a branch of pure mathematics. As a result people who should have been trained to make engineering tradeoffs instead obsess about things that don't matter to the job they are actually doing.
Software engineering is more online and connected than most professions. A lot of devs grew up in an era where building your personal brand was touted as the most important thing you could do for your career. They watched certain peers vault themselves into local fame and maybe fortune by going all-in on Angular or React or Go or Rust or Bitcoin at just the right time. In some cases, being dogmatic or cult-like about something and spreading the mentality that it’s the best option without tradeoffs becomes a self-fulfilling prophecy.
If enough people spend enough time declaring microservices or agile or Bitcoin to be the one true solution, it starts to become accepted as true. Those who were at the forefront of promoting it stand to gain a lot by being there first and establishing themselves as experts in the field.
I see contrarianism in small parts of most fields, but software seems to uniquely reward contrarianism. Agile was the contrarian methodology until it became popular, at which point anti-Agile became contrarian and is now growing in popularity.
Like, 9 women cannot give birth to a baby in one month.
Management is fine as long as it's a cog in the production chain; you can generally know if your management is healthy if the IT/Dev budget comes from the IT/Dev leads and if the contracting work requires IT/Dev signoff.
I get it, most places around see management as the steering committee, and quickly become disfunctional as their focus shifts in justifying their own budget, but that's because IT/Devs are a century behind in establishing their profession as specialists like lawyers and doctors and often find themselves in blue collar type positions, not from a specific property of having "management"
Just look at hospitals and lawyer firms, you'll find seniors doctors and lawyers at the top, and accountants in their own dept, and not the other way around.