For years, the story of American healthcare has read like an obituary for small, independent medical practices. Faced with shrinking reimbursements, staffing shortages, and rising administrative burden, many physicians traded autonomy for stability, selling to health systems or private equity. Yet beneath the consolidation headlines, a quiet rebellion is taking shape. Across the country, small specialty and multi-site practices are not only surviving but posting strong margins. They’re lean, tech-forward, and operationally disciplined, proving that small can be powerful when run like a high-performing business.

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