Have you or your patients suffered from shortfalls in administrative support that have adversely affected your care? When you have inquired about the cause, have you been told, as if about an immutable force of nature like the weather, “It’s the supply chain” or “Everyone is having trouble hiring” or “It’s budget cuts” ?Since the time of Hammurabi, clinicians have been held accountable for their decisions and actions that affect patients. Harm from clinical interventions has been much better delineated and significantly reduced in the two decades following the publication of To Err is Human. However, injuries to patients and to clinicians are increasingly arising from a newly described source, administrative harm.  Until recently, administrators in healthcare have played a supporting role. However, as the numbers and decision-making power of administrators in healthcare have burgeoned, the vulnerability of patients to the consequences of administratively driven interventions or failure