Here comes the the big three...

Inflation – too many dollars chasing too few goods.  We also have an abundance of college educated workers but too few in blue collar trades so prices are increasing.

Doctors are in the cross hairs of the proposed tax increases due to the physician income.  Congress proposes to increase the tax rates but also increase the tax brackets.  Now lower income will get you to a higher percentage tax bracket. Estate taxes are also proposed to increase which will affect physicians as well.

Reduced income – physician income has been historically stagnant or marginally increase that does not keep place with inflation.  You would need a 3-4 % increase in salary each year to protect your buying power anything less you will fall behind.