Contrary to popular opinion, doctors have close to zero bargaining power in the US. That's why private practices have been rapidly shutting their doors over the last 10-15 years - they've been losing money, so they've had to sell their practices to large provider networks. But even those hospital networks don't have much bargaining power, which is why many of those have been going out of business and either shutting their doors or consolidating in the last 5-10 years.