natnicnak,I am not sure the PRY model works as well for...

natnicnak,
I am not sure the PRY model works as well for specialists who operate. A GP can struggle to keep their cost below 50% of personal exertion because (relatively) all their revenue is from consulting where they need rooms, staff, nurses etc. Surgeons get most of their revenue from performing operations where most of their capital and staff needs (unless it is their own facility) are provided to them at no cost (by the hospital). Most should able to take home at least 75% of personal exertion revenue.

That means that the package that PRY can offer GPs is always going to be more attactive than the specialists.

The initial buy out made the specialist practice sale attactive, but once the share value is lost, the deal looks a bit sour - unless it is managed very well and effiently.