Private practices in the US have been declining for decades. Most Doctors today are employed by a hospital or other provider network. This trend has only accelerated since the pandemic as well. As a result of this Doctors have had no choice but to run their practices as a business. This is why they now require you to have a credit card on file, why there's cancellation fees, and why you don't actually see the Doctor until almost an hour after your appointment. They are simply triple and quadruple-booked. They can not choose their volume. This trend has been well-documented. See:

https://www.ama-assn.org/press-center/press-releases/ama-ana...

https://www.healthcarefinancenews.com/news/nearly-70-us-phys...

https://www.webmd.com/health-insurance/news/20210527/more-an...