Its designers knew that it would be in constant attack. As a practical matter, that means the only way to beat it is by mass noncompliance. If fifty people walk in, by God, it's a revolution. Several other unpleasant things would occur simultaneously. Government edicts are non-negotiable.
Willful noncompliance is illegal.
The government would immediately tell patients that the reason their services have been interrupted is because of those greedy physicians who are putting them at risk by acting in a selfish and antisocial manner. They have become Teamsters. We only work if we have our foot on the neck of management. OK, let's argue further that physicians could be whipped up into such a frenzy that Jimmy Hoffa's millions of molecules buried somewhere in a bridge abutment in New Jersey all quivered in syncopation. We pulled it off.