Just as President Obama has signed new health care legislation into law, another change is quietly happening, the New York Times reports: more U.S. doctors are moving away from working in small, privately owned clinics, long the most widespread form of health care delivery. Instead, more young physicians are working in hospitals and health systems, often driven there by medical school debts or the search for more regular working hours. What’s more, a growing number of older doctors, who face rising costs and the worry they won’t be able to recruit younger partners, are selling practices and moving into salaried jobs. For patients, bigger health care groups can provide more coordinated care, but the intimacy of doctor-patient relationships may be lost, the daily reports; and while big organizations might be more efficient, they can also contribute to the rising cost of private health insurance, as they give private insurers less negotiating power in setting rates. New health care legislation does little to mitigate this, instead containing provisions (like efforts to combine payments for some kinds of medical care) that might further speed the growth of Big Medicine.