Still More About Money
More with the comments:
OK, so you're a good doctor and you are smart. Here's a test for you... do you make more money seeing patients or analyzing reimbursement from certain payors?
I know lots and lots of very astute business people who are also physicians. My wife is one of them. The reason they are good business people is that they realize where they make money... in the exam/treatment room.
Hire someone who is good at watching over things, stay in the loop, but generate more revenue and you'll be happier and more financially successful
How the hell am I supposed to "hire someone" when I can't even pay myself!
What you don't seem to grasp is that there are places in this country where a completely optimized medical practice still doesn't generate the kind of revenue you're talking about. It is a myth that if a practice isn't doing well, it's the doctor's fault for either not working hard enough or smart enough. "Just get into that exam room and see more patients" = "Why can't they eat cake?"
Again, an apparent solution would be "so move." But doctors are not fungible; a commodity easily interchanged by physician recruiters (oh, lookie: another lucrative middle-man industry that doesn't actually provide healthcare.)
There is more to business than being astute. Perhaps one could say that my only bad decision was in setting up practice in an area like this, but as it happened when I began the practice it wasn't like this. The environment (the BUSINESS environment) is what has deteriorated over the years. This is not the kind of thing that even business people can predict (though now that I think about it, they're the ones who caused it.) What they can do, though, is move on to other industries, whereas I'm "stuck" because there are 2000 people here I care about and who need me.