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You might want to post this over at the Physicians and HC Professionals Board:

What are the main factors to consider about 1 year out from the opening of a new practice?

A lot of the same questions anyone would have when starting a new business. Do you have business plan? Why don't you take a look at Starting Your Business from CCH's Business Owner's Toolkit:

What is going to be the hardest part(s) of the next year?

Dealing with referring physicians, patients and insurance company garbage.

There is only one hospital in town. Can the group exert pressure on my creditialing there? If so, how do I fight back?

They can do whatever they want - whether or not it's legal is a different question. However, think of it from the hospital's point of view - one more surgeon = lots more revenue. I don't think you'll have too many problems getting privileges; however getting the OR time that you want or getting any special equipment you'll have to fight the other urologists in town for it. Any they, as a group, bring in a lot more revenue for the hospital than you will be able to alone. Therefore, they will be favored in the eyes of the hospital.

Also, many hospitals now have their own insurance. The urologists in town may have signed an exclusive contract with the hospital. If so, things will be even harder.

I'd do a lot of research before I hung my shingle.

Good luck,

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