ok. The answer would depend upon the hospital's case mix and payor mix. While there are many inpt rehab physicians who do their own billing/collections, this model is falling out of favor. Mostly because reimbursement is low, and it really helps to have that medical directorship to add to your income. The hospitals want their medical directors to be employees so that their interests are aligned. Also, the growth of ACO's and bundled payments are making aligned interests even more important.Let say you get a job offer where you are paid as an "independent contractor" or where you admit to a rehab hospital as an independent contractor. how difficult or expensive is it to setup the business thing needed to be successful. Like accountant, billing service, or LLC. Is that something that would require that you have a enough money to absorb those cost upfront and continue paying bills until the collection come in 3-6 month later. Just trying to understand other models of practicing besides "salary or salary with productivity model". I've worked pretty hard and in theory would like to "eat what I Kill"