This episode, ironically, highlights two problems of Janeway that Chakotay excelled in as Captain. First, he made sure people were promoted accordingly... there's something to be said about having that kind of reassurance that your hard work does merit something more than just a few more replicator rations or whatever. (Though considering how the Year of Hell really did a number on the crew count, they were almost certainly necessary promotions to fill those gaps in positions.) Second, it was mentioned that Kes was one of the DOCTORS on the ship, which indicates there are multiple doctors besides The Doctor. That should frankly have been one of Janeway's first tasks once they got stranded in the Delta Quadrant... train more crew to be actual doctors. (To be fair, in "PARALLAX", she did assign Tom to be a field medic and later Kes became that, and Tom got be field medic again once she left. But while field medics are important, having more trained doctors is even more important, especially since The Doctor is technologically based. Going through the Year of Hell without him online was exactly what they needed to prove that the ship needed more than just him as their practicing doctor.)