I've talked to other people who work desktop in this industry, and it seems to be the same all over the place. Most of the managers of IT are clinical people rather than IT people. They regard IT as an unnecessary evil, and would rather it be gone completely. The organization is setup so that no one can tell anyone no, least of all us. They don't care about job descriptions; here Desktop Support is a catchall, but they tell us that we're being paid the industry standard for Desktop, so we should be happy.
So, when someone puts in a helpdesk ticket asking me to write them an access database, or fix one that they broke I have to do it. When someone puts in a helpdesk ticket ordering 100 computers, I have to do that. When someone wants an app written, I have to do that. When someone picks out some damned vendor package against our objections, I have to install it on the desktops, install it on the servers, and maintain both.
Yes, it is in a flyover state, but my pay is still low for the area if they would pay me based on what I do rather than my job description.