Well, no surprise here.
Because of socialism now pervading medicine in the U.S., many of my doctor colleagues have seen their income plummeting, volume of patients skyrocketing, and ability to practice quality medicine severely degraded. So some have recently shifted to "concierge"-type practice, where the liberty of capitalism may regain some life. Here, patients pay about $2,000 a year to join the practice and supplement the payments from insurance or Medicare, which are so low that they cannot sustain a medical practice. This guarantees a reasonable profit for each patient. Such profit is, as always, the main driving force, the powerful incentive for excellence, high quality, and fine customer service.