US Doctors running small practices going broke??

An article about US Doctors running small practices going broke.

I was of the view that small practices are amongst most profitable small businesses inspite of payout pressures from insurers (The 20 Most Profitable Small Businesses)

Reasons for small practices going broke being cited by the author are shrinking insurance reimbursements, changing regulations, lack of business acumen in clinicians, rising business and drug costs. The article is also indicative of decreasing profitability of small practices and rising pressure on providers due to healthcare reforms.

If doctors are not earning in US, but costs are rising...where is the money from increased costs getting channeled to? Is it that healthcare consumption is going beyond healthcare Requirement ...? or Is it the over indulgence of US with high end medical technology or the indiscriminate use of high end pharmaceuticals. In my view, the most immediate reason to which causality of increasing costs can be attached is the Healthcare consumption going beyond healthcare requirement.  

If the article is representative of true picture, then in the long term it will be more profitable for the physicians to be associated to large providers and practices which have the required economies of scale to sustain the indirect pressure being transferred by healthcare reforms.

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