Quality Assurance meetings were a nightmare because the Medical Director wanted his clinic(s) to have the best statistics for lab values, especially protein and phosphorus. When the numbers didn't meet his expectations, he blamed me, the dietitian. The administrator told me to play Bingo with the patients to help them remember what to eat. (This idea had not worked well in the past) They expected me to "fix" the patients' eating habits. Telling the Medical Director and Health Care Team the barriers to improving the clinic's statistics was not important. The only important thing was having "good numbers". The Medical Director has every single trait of a Narcissist: Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements) ◾Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love ◾Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people ◾Requires excessive admiration ◾Has a very strong sense of entitlement, e.g., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations ◾Is exploitative of others, e.g., takes advantage of others to achieve his or her own ends; blames others to make himself look better and not responsible ◾Lacks empathy, e.g., is unwilling to recognize or identify with the feelings and needs of others; especially the patients and staff ◾Is often envious of others or believes that others are envious of him or her ◾Regularly shows arrogant, haughty behaviors or attitudes He does not have acceptable attributes to be a Doctor and was doing it for the money. He was highly educated with multiple degrees, started college at a very young age, and came to the United States to have a better life.