Traditionally physicians were small business people, working alone or in small groups. Increasingly physicians are becoming employees or partners of larger organizations. The barriers to entry as a solo practitioner are increasingly steep and risky – while groups afford power to negotiate fees, invest in practice infrastructure such as record systems and equipment, and allow young and often debt-burdened new physicians the ability to enter a practice as an employee without personal investment. Furthermore, the increasing complexity of contracting and payment with multiple payers leads many physicians to seek to avoid the business end of medicine and leave it to others while they treat patients. This New York Times article describes the trend.