US physicians are struggling to pay overhead and deliver quality care.  Many practices are selling to hospital systems, large corporations, or venture capital.  Others are trying to solve the financials by working harder, treating more patients, and taking more call.

At this point, many physicians run the practice at break even or a loss and take call at 2-3 hospitals to float the practice.

Burnout is real and increasing at an alarming rate.  The current situation is bad for physicians and patients.  Both suffer.

I opened my practice 11 months ago.  I will make less this year than my first year in practice, and that is not considering inflation.  This is despite working like I did in residency. 

I oscillate between pushing on for my community and my family and calling a dinner to inform my team its time to close it all down.

As a side note, when I started practicing in my community, we had 12-15 urologists.  We now have 5 and 3 of them are 60+.

I get messages every day asking me "How did you do it? How are you surviving?"  I'm not sure I am.