Afaik it has to do with licensing regulations and litigations…
A doctor is licensed to practice by the state, and must carry insurance on a state-by-state basis to acquire a license to practice.
The problem is that if you get sued 3 times you get blackballed by the insurance industry in your state and the insurance companies won’t insure you.
You see a lot of doctors moving states often, its often because they became un-licensable in their former areas.
I have limited industry experience and have talked to quite a few doctors who were indeed a bit distant and hands-off in their practice for this reason alone.