I've seen a General drop a JDAM on friendly coords (thankfully, they were fully retrograded). Nothing happened.
A Wing Commander dropped a BDU on a Maverick pass on a check ride. He got a downgrade.
I have numerous other examples. Bottom line, we shouldn't expect too much out of our senior leaders tactically because they are too busy leading. Gone are the days of Sr leaders having street cred (some do, most don't). So, I'd venture to say after one makes O-6, hands don't matter. So why should hands matter for the chosen ones making it to the coveted Sr leader level?