Steadily declining reimbursements (Medicare) and ever increasing overhead lead to overall less income. Regulations (HIPPA, etc) don’t help morale or costs. Soon medicine may be one of those “jobs that Americans won’t do” leading us, like the UK, to have to import laborers to fill the void.
It already is a job that more women than men are willing to do, based on med school enrollments, which means that much potential talent in our male population is choosing other work -