"In clinical practice, physicians are well aware of risk management. But in many parts of the country, the majority of physicians have already lost the risk battle when it comes to the management of their business. As a result, they are now either employees or out of business altogether," Dr. Michael Cassaro wrote in a guest commentary on FiercePracticeManagement. Not satisfied with either of those options, he chose a different path: becoming an out-of-network physician. "This was a five-year process--of dropping my worst payer, losing some angry patients, waiting for the schedule to fill back in, and repeating with the next-slowest, smallest or lowest-paying payer--and then doing it all again," he continued. "But the goal was not necessarily a 100 percent self-pay practice." FiercePracticeManagement