History of medical decision making:

1900-1980 (post Flexner era): physician driven 

1980 to 2020 (employer based insurance growth/managed care boom):

Insurance/Institution driven decisions

2020 - present (post-COVID/GLP-1):

Patient-driven clinical decisions

Physicians (unless in acute settings) will have a hard time competing in this space since most were trained in a bubble of not worrying about the business side. 

Will have to either learn fast and treat yourself like a startup, or go into acute care where insurance will stay strong (but control your pay and quality of life)