Between patients delaying surgeries or cutting back on preventative care to avoid co-pays, and with major reforms in health care, private medical practices and hospitals are taking a major hit. During the economic recovery, the bottom line for many medical businesses continues to be impacted. Many private practices and hospitals are cutting expenses and staff to make ends meet. Health-care spending in the United States is projected to grow at a historic low of 3.9 percent in 2010, said Dr. Melayne McInnes, an economics professor at the University of South Carolina. "In past recessions, the health-care sector has been hit with a lag. But in this recession, the health-care sector was hit immediately," McInnes said.