Can you imagine trying to run a company where your subcontractors told you who to hire and what to pay?
Concerning the Maui radiology fiasco: If the local group was so great, why did it come out dead last out of four proposals? Sounds like some very entrenched physicians don't want to give up that extra $600,000 over and above what it takes to run the service. If it was not about the money, more of them would have signed up to work for the new management company, which I hear was open to hiring them.
You can be a good doctor and not be a good manager. Maui has a capable administrative staff and a smart board of directors who have taken a floundering institution and attempted to turn it into a real hospital that can compete with any hospital in the nation. If the local doctors don't get with the program, they become part of the old problem. The old Maui Memorial Medical Center had a power vacuum that many tried to fill, including selfless but also self-interested local practitioners.
The doctors don't run the hospital, nor should they. Look what happened to St. Francis on Oahu when the doctors took over - it went bankrupt.
Let the system work.