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There was a time when hospital or large group employment felt like the safe choice. Predictable income. Built-in infrastructure. Someone else worrying about staffing, compliance, billing, and contracts. For many physicians, it felt like a reasonable trade—give up some control in exchange for stability.

But over the past several years, something has shifted.

More and more physicians are realizing that while hospital or large group employment may reduce certain risks, it often introduces a different kind of cost. Less autonomy. Less flexibility. Less influence over how medicine is practiced day to day. Schedules are set by committees. Compensation models feel disconnected from effort or quality. Decisions that directly impact patient care are increasingly made far away from the exam room.

That’s why today we’re talking about buying back your autonomy. Specifically, when—and how—to leave the hospital system and build your own independent practice.

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