Without derailing this discussion, yeah this happens but only at a later stage in your career where you have the 'name recognition' in your subset of surgery so

Without derailing this discussion, yeah this happens but only at a later stage in your career where you have the 'name recognition' in your subset of surgery so that your colleagues trust you enough you to even bring you in as a partner. I'm limited to the NE region, but I've never once seen a surgeon or medical practitioner form his/her own association or join in as a JP into an already established association until they were well out of the burden of debt. In the same way that attorneys generally don't go straight into the market and form Johnson, Thompson LLP until they have a few wins under their belt at Skadden or Cravath and a few clients they know they can bring over, your typical niche association won't hire you into their surgical association even with half a decade out with a bunch of articles with you as lead surgeon in high-impact journals. You're still considered a risk as a partner (nepotistic situations notwithstanding).