America’s doctors are working harder and getting paid less. And that could soon translate into less access for some patients.

The big picture: A new report from consultancy Kaufman Hall shows primary care physicians and specialists are delivering more services since the pandemic. But they’re not making more money because of stagnant reimbursements from public and private insurers and inflation.

Meanwhile, bankruptcies amid smaller practices of between $500,000 and $2 million in revenue have been steadily rising in the last two to three years, said Daniel Gielchinsky, a partner at DGIM Law in Florida who specializes in bankruptcies.

The intrigue: Among the disturbing trends Gielchinsky has observed are medical practices branching into med spa-like services and investing in Botox supplies and skin-tightening lasers in hopes of capturing wealthy patients seeking elective procedures.

They’re finding out that consumers have less disposable income than they expected, and the competition is fierce.

“We had one bankruptcy where the equipment was literally unused. They didn’t get a single patient in the door to do any laser treatments, but they’ve had this $800,000 machine they’re making payments on every month,” he said.