When I was 40 years old, and 11 years into practice, I started to plot my premature retirement from medicine. The community hospital that had owned our practice released all employed physicians and later closed its doors. Our office joined a large multispecialty group with a coercive management style. Overhead increased dramatically. Doctors were threatened with pay reductions if productivity benchmarks were not met. Collection of insurance reimbursement was suboptimal, and the system favored doctors who saw very high volumes of patients. Physicians were expected to serve on several time-consuming committees. Our rent increased yearly, while our reimbursements decidedly did not. My 2 favorite partners quit the practice and moved to a small town. I was miserable.
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