In Florida, some hospitals are allowing their docs to "go bare" because the alternative is to run hospitals without docs. This puts a horrible burden on hospitals. Everyone looks at hospitalization bills and calls them "doctor bills"--the main drive to your increase in health cost is not the cost of the doc, it's the cost of the infrastructure of the hospitalization--that vast plant of equipment, technicians, maintenance, and administration. If I could get insurance where I paid my doc out of pocket and had my hospitalization "free"--I'd be a very, very happy patient.
Penn is an interesting place because traditional crime thuggery has long joined forced with the trial bar--only mass resignations could change this. The citizens love their bandits more than their docs and hospitals.