[jxramos]

The secret is to find independent doctors who have their own private practice and who have hospital admit privileges. Also physicians who take cash payment and operate outside a big health organization or who have affiliations with them but don’t answer to them.

[eszed]

You're right, but local independent physician business model is being destroyed by insurance requirements. I have an uncle who ran an office like that for 20+ years. He employed two nurses, a receptionist, and a full-time coder (for those of you who don't know, that job is the translation layer between medical services and insurance companies). I don't know the economic details, but lately he was spending too much of his own time arguing with insurance company medical "experts", and facing hiring a second coder. He closed his practice, and semi-retired. He's bitter, and doesn't think there's any route to physician independence beyond cash-pay / concierge care. (He's not a speciality that lends itself to that model.)

[asdff]

The danger is whether they keep up with the field or just continue what they learned in their time in medical school. At least with a major hospital they are surrounded by other experts in the field including a batches of newly trained doctors.

[jxramos]

There’s an OBGYN we’ve long had a relationship with who takes on residents and cross pollinates with them for a win win knowledge transfer. They also volunteer overseas with charitable medical efforts. Those are probably interesting avenues for keeping up with things from the outside to some degree I imagine.