Convoluted exemptions exist for hospitals and GPOs, exeptions from federal anti monopoly and anti kickback laws which are strictly enforced against medical doctors.
This hypocritical policy conceived and enforced by Congress (accepting Big Med lobbyist contributions and consulting jobs after leaving office) is designed to hogtie individual
medical professionals from independent practice, essentially enslaving the medical professional class as service employees of Political Class Healthcare Industry.
Solution: Indian Reservations are sovereign law.
Hospitals placed there, offering price-posted medical services, especially elective surgical procedures, could win back big medical tourism dollars.
Patients even with insurance are beginning to realize they are indeed cash payers, when they grasp the effect of deductibles and co-pays.
Why not harness the economic power of such demand to create an honorable source of supply? Especially when the largest chunk of the medical transaction dollar is now being taken by third party gatekeepers who add zero value to the trade.
This is Positron social-economic-political self defense tactics: use the same methods the self-dealing Political Class uses for narrow self enrichment, but use the methods for the opposite purpose: equitable distribution.
In this case, Political Class perversion of the law is their method. Can't beat them in that arena, they Own "the law".
So find out where they don't own the law, and set up competitive shop.