The European management team has always had a poor understanding of the US market dynamics and cultural attributes. The rigidity with which both corporate and business policies are applied are completely misguided and the management's perception of reality is quite distorted. Very talented people have been attracted to the organization over the years yet the management's inability to retain and cultivate this talent, especially since the fourth quarter of 2016 is appalling and the attrition rate is significant in all departments. It has always been a mystery to outsiders as to how such a company could acquire high levels of talent and then dictate to them how to execute in their native market without allowing them flexibility or constructive inputs to be applied with at least some level of reasonable oversight. Leadership is present in the German office but the US office receives little more than mid-level, college text book managerial guidance and what it does receive, is dictated in application by the vision of the German office's senior management. Family manages both entities (father, son, daughter in-law) with very few years of multi-organizational experience in the US, yet the company appears governed somewhat by a seemingly competent board of directors which makes for and interesting study in corporate dynamics. This creates a troublesome set of factors when the market place struggles with coding and reimbursement issues and a business model that is continually strained under the weight of multiple competitive and specialty based factors.
