GM ran its business into the ground by becoming focused on everything other than building cars that their customers wanted. They didn't even understand who their customers were (in the car business, manufacturers hold to the belief that the dealers are their customers). But when people stop buying cars, the dealers stop buying cars and the whole system slows or shuts down.
It's 2:30 p.m. and you're in the O.R. in the middle of a case. Your phone rings and it's the [hospital administrator/your CPA/your biller] asking you to make a decision that will impact your practice and perhaps even your bottom line.
It's widely expected that the decline in the stock market and the recession in general will force large numbers of physicians to work beyond their projected retirement dates.