work as employed physicians. It is important to look at a variety of market indicators including available job openings for doctors, statistics on the best cities and states to practice medicine, demographic information on medically underserved areas, current listings of medical practices for sale, and the type of assistance available for financing a practice start-up or acquisition. When pursuing the independent practice route it is vital to get grounded in basic accounting and the management aspects of running a small business. Though medical practices differ greatly from the average small business, a practice is still subject to many of the same factors influencing other small businesses. Business skills are not typically acquired in medical training and finding a balance between business management and clinical practice can be tricky. Regardless of the practice decision made, proper due diligence and learning opportunities related to physician employment, practice purchase options, and startups take sufficient time. For those who set their heart on ownership the difficult decision of whether to buy a practice or start one from scratch can be challenging. Depending on the availability of opportunities on the market it may be more practical to buy a medical practice instead pursuing a start-up, or vice versa. The decision to start-up versus making an acquisition is also dependent on where the doctor is looking to practice medicine and how they envision building their private practice. Buying an established practice with existing patients and cash flow is often cited as a better option than beginning fresh, but a start-up medical practice can be equally rewarding and profitable.