Is the practice going broke or the doctor? It wasnt clear. The doctors can "earn" whatever they like, but if they are pulling too much of a salary, then it is their own fault.
If their overhead is too high, it is their own fault.
Sure, insurance limits payouts, and there are risks, insurance needs, etc. I get that.
But every insurance payout that I see indicates that the doctor is getting PAID the equivalent of $350-1000/HOUR! And that's being generous and saying that I actually saw the doctor for 15 minutes, which is not the case.
So at $400/hr, the doctor can take home $100/hr (which is $200k/yr, which even if that is a "burdened" rate, equates to $100k/yr, a fairly cadillac health plan, 401k, overhead to keep the lights on, etc). Then the practice can pay SIX people $50/hr burdened rate (which comes to say, $25/hr ($50k/yr)) for a few office folks, and some rent.
Im not seeing the problem unless the doctor is expecting $250k plus support staff and everything else.