There seems to be some disconnect in your logic. For private practices, how does an increase in candidates drive salaries down. A private practice hires what it needs. They don't overstaff. Just because there might be a market oversupply, doesn't mean I have to hire. And it's unlikely someone will come in a plop down a center in 2018 next to an existing one if you don't have the referral base which we have built through hands on personal relationships and high quality care. Our reimbursement and hence salary are controlled by two things - Medicare and commercial payors. Medicare we have no control over, but there is no clear indication of a fiscal cliff, though it will tend down based on how the medicare pot works. Commercial payors we negotiate with and have dialogues. As for satellites, you should be aware, that ever since the ACA passed, many are going into hospital employed models. Pretty analogous to satellites (which actually do pay more than their academic counterparts in many scenarios, or have 3-4 day work weeks). This is a trend in all of medicine currently, and most prevalent in desirable regions of the country - ie california, Northeast, major cities.