I'm not sure what you do, but lets say you're a programmer. You love programming and want to make the world better with it. Of course you also have $400,000 in education debt from becoming a programmer and need a job to ensure you don't end up bankrupt. So you get a job for $bigCorp that pays well. BigCorp tells you that you must push out 100,000 lines of code per day or you're out. You look around and all the jobs in what you do pretty much act the same way, and those bills are coming up at the end of the month. Now, you know you cannot turn out quality code at that rate so you cut back quality to a bare minimum to meet the metrics of continued employment.
Most doctors are in a similar situation these days, very few independent offices exist. They are parts of "GiantHealthCareCorpofAmerica,INC" that cares far more about how much the shareholders are going to make than how the patents are, even though each individual doctors would like to give better individual patient care.