How to "play the game" with administrators? I am the medical director of a dialysis unit, and over the past couple of years, there have been a lot of policies and procedures pushed onto us to adopt. I am given "autonomy" as the med director to either implement a policy or not, but if I decline, they have a way of making things intolerable. I recognize that I am a mere cog in the giant machine, but dialysis patients are a vulnerable group and I ferociously advocate for them. Where is the balance between taking care of patients and not being a thorn in everyone's ass? I certainly don't just want to be oppositional in principle, and "choosing one's battles" is important to keep in mind. At the same time, if all of the policies brought forth seem to be bad ones, I don't like the idea of accepting some of them just to save up the good grace to turn down an especially shitty one. If I'm given the power to make a decision, should I not exercise it as I see appropriate regardless of pressure from above?…