> How doctors of all professions lost their professional agency to do-nothing administrators within a generation is quite puzzling and a bit terrifying to me.

I would bet it's caused by:

- stifling bureaucracy

- hostile legal climate

- massive start up costs

The only winning move is not to play. Let the system fall apart and join on the later upswing. The unfortunate part is all the needless suffering people will endure during this process.