this - though I don't believe incomes really keep pace with

inflation for doctors. And even if they did, they would not be as wealthy as they were years ago, given the much larger debt load that current doctors carry.

As practices coalesce around large hospital systems, care gets more expensive, not less. Been happening since Obamacare mandated all the reporting.

1) Fragmentation of care between multiple covering doctors, no one of which has ownership over the patient's outcome results in duplication of services.
2) hospital employed physicians can bill at higher rates due to better contracts with the payors based on large amount of market share in an area increases cost, but does not increase doctor salaries or quality. Excess cost goes to the hospitals - for example, one large hospital system in Virginia has liquid funds equaling 1 year of revenue, so they would not have to go into debt even if they did not collect 1 dime over the next year. Their hospital employed physicians in my specialty do not make as much as I do, but their patients' care costs almost twice as much per visit.
3) hospitals mandating primary doctor referrals to other hospital providers who are also high cost. Technically illegal to mandate, but they are give bonusus based on percentage of patients they keep within the system.