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The reason that we are starting to see this is that managed care is just squeezing physicians in a rising cost environment so they simply can't afford to perform services without charging. Physicians don't want to antagonize their patients, and they don't like pursuing these strategies, but there's no choice.

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What we fear doing most is usually what we most need to do by Tim Ferriss
Optimistic people see opportunity in every difficulty, whereas pessimist only sees the difficulty in every opportunity by Winston Churchill
The doubts you have today are the only limits you put on success tomorrow by Franklin Delano Roosevelt
Things may come to those who wait, but only things left by those who hustle by Abraham Lincoln

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