Primary care doctors struggling to survive - Los Angeles Times

Primary care doctors struggling to survive - Los Angeles Times: "Small general practices afford doctors autonomy to practice medicine as they see fit and can produce strong doctor-patient bonds. But these physicians have little or no clout to leverage better payments with insurers; they have no economy of scale, which makes overhead more burdensome.

'It's very difficult, even in rich neighborhoods like Beverly Hills, to set up a solo practice,' said Richard Scheffler, an economist at UC Berkeley. 'The doctor has to pay rent, a nurse, have a bookkeeper, billing systems, computers. All of those fixed costs are very, very hard for a solo practitioner to have and survive.'"