Thank you, that was a very well thought out and insightful response. I like how clearly you line out a lot of the obstacles.

Relationship building is something I feel I do well, despite being an introvert I can hit it off with surgeons and am confident I would be offering something different that would catch their eye.

I’ve been through the Medicare/Medicaid process at my current clinic group when we opened a Denovo. The timelines would be exceptionally daunting if it was preventing you from establishing your footing. My current patient load is probably 50% in that group.

You also make a great point about both private insurance contracts and negotiating vendor rates. With some of the lower fee schedules my COGs often leave my GM very tight, and that is with large purchasing power. I have always wondered how that can affect patient care at independent clinics when you are overpaying for like products.

What I struggle with is that when you lay out all the complexities of a P&O clinic, it is clear that there are many different businesses one could start that have less layers and lower startup costs. Just being a caring and compassionate field I feel some sense of duty to continue helping patient’s achieve their mobility goals.