If I have only moderate hills around me (14% over 1 to 2 miles), why can't I keep an 11/32 cog, but have a single 42 tooth chainring up front? My current set-up on my TT turned Road is a 56/42, but using the 56 kills my knees and I just don't use it. Does anyone run a single chainring?

Talk to the guys at your neighborhood bike shop. They can swap out chainring in front, or put on a new cogset in back. Back in the "old days", many riders had two or three rear wheels, each with a cogset designed for specific riding goals. Today, most cyclists have a "one size fits all" approach, but the standard road bike setup probably is not appropriate for 80% of the guys riding roadbikes.

What does "standard road bike setup" mean? It seems that pretty much any bike is offered with triple, compact, or 53/39 cranksets. I think one of those would be appropriate for 99% of the riders out there.