I guess what I want to know is what is meant by autonomy.
I just opened a new "corporate" practice. I picked the location, approved the building plans as well as made necessary changes that were included. I picked out all my equipment to build out 6 chairs... top of the line stuff too! I picked out the decor and have a hand in everything that was done to get it finished.
I consulted on the marketing designs, the logo, and what advertising we did to start out with.
Clinically, I decide all treatment and what is done on whom. No one comes in to tell me to do a crown when a 3 surface restoration will suffice. No one tells me to do a restoration when a crown would be better. I choose to do all my own endo, extractions and pros and refer out when appropriate. I pick all my own materials and labs that I use. I was involved in the hiring of all my team and had the final say on it as well. I was involved in deciding all of their salaries.
I choose what hours I work, when the practice is open and when I go on vacation (granted, I could use a little more of this!).
I am fully involved in my profit and loss statement and know what is spent on each line. (By the way, my team knows all of this as well!)
Here's what I don't do, but let the "corporate" guys do for me: Negotiate higher reimbursement on PPO fees than my collegues down the street. Negotiate substantially lower costs on all my equipment, labs, clinical supplies and office supplies. Take care of payroll and all other accounts payable (I just send them the statement and they write the checks....). I don't take all this junk home with me at night or stay at the office a couple of hours afterwards doing all the above listed stuff.
To be honest, I don't know how much more "autonomous" I can be. I guess I could be in possesion of the checkbook, but that's about it. Anyone who blankets a "corporate" practice with not being autonomous without knowing anything about it is showing "ignorance" in my opinion....
Just my two cents.....
JKM