If you are in the right area it is certainly possible to do it independently. It will be a steep learning curve on how to document and bill correctly, schmooze the admins and primary care docs, manage insurance companies, fight denials, keep up with MIPS/other requirements. But obviously it is possible since many in the past have done it. Extremely difficult to set this up in a urban city since the groups can be very aggressive. YMMV but due to geography I prefer staying with a large group. That decision has saved me various times and my life is a lot simpler.