You bring a license and a small business. We bring hospital contracts, a pre-built care team, and credentialing infrastructure. You decide how much you work, where, and how often. Earn equity where you practice.
We’re a managed service line for rural and community hospitals that can’t fill their endoscopy block. We hold the hospital contracts and run the wraparound care team. The procedures themselves are done by independent GI doctors who run their own practices and contract with us for hospital access on terms that work for their lives.
No W2. No production targets. You’re a small business and so are we — we do business together. And as you participate, you accrue ownership in the regional practice itself, alongside the other physicians who deliver care through the network.
You handle what you handle when you’re a private-practice physician anywhere. We handle the parts of solo practice that take years and capital to build on your own.
One week a month is fine. Full time is fine. Doing this on the side of an employed role for a year while you transition is fine. We don’t care, and the hospitals don’t care, as long as the block is covered consistently.
Take one block a month. Useful if you’re semi-retired, transitioning, or running this on the side of another role.
Comparable to a part-time employed schedule on cash, with substantially better flexibility and lower overhead.
~36–38 working weeks per year — Cash well exceeds MGMA median GI; Unprecedented quality of life.
You can ramp up or ramp down between rotations. Drop a hospital. Add one. Take three months off if your kid is graduating or you want to travel. As long as you give the network advance notice so coverage stays continuous, we’ll work it out.
Rural endoscopy doesn’t require living somewhere remote. Two coverage models work, and you can mix them.
If you live in or around the Mid-Atlantic, parts of New England, or the Carolinas, several of our hospital sites are inside a 1–3 hour drive of where you already are. Drive in, do your block, come home that night or stay locally for the 3 procedure days.
If you live further from the network, fly in for the work week. Standard visit is one fly-in day, three procedure days, one fly-out day. Same hotel, same route, every month, on a route you helped pick.
Plenty of doctors mix the two: drive to the hospital that’s ninety minutes away one week and fly to the one in West Virginia the next. We work the rotation around what you want, not the other way around.
In a traditional private practice you would have to hire and train this team yourself. Here it’s already running. You walk into a procedure suite where every patient is eligible, prepped, and on time, and you walk out without a follow-up phone tree to maintain.
If you’ve never operated a PLLC or S-corp before, your accountant can set one up in a week. The benefits compound: every business expense (CME, equipment, mileage, home office) is deductible, you control your retirement contribution ceiling (Solo 401(k) up to ~$70K/yr), and you decide your own salary vs. distribution mix.
Net result: for the same gross income, an independent contractor with a properly-structured S-corp typically takes home 8–15% more than an employed W2 physician after taxes and retirement optimization. We’re not your accountant — talk to one — but the math is well-documented in the physician-finance community.
Each contract you hold with CEC accrues shares in the state-level Professional Corporation — the physician-owned practice entity that holds clinical privileges across the network. This is on top of your contract compensation, not in place of it. The economics are recurring partnership distributions, not a one-time exit payout. A physician group practice, in other words — just one that doesn’t require you to build the rest of it.
Specifics on share count per contract scope, current valuation, and buy-back formula are handled in individual conversations as part of finalizing your contract. We’re describing the structure here, not committing to a number on a webpage.
If you’re reading this page, you’re probably weighing this against a hospital W2 role or a locum agency contract. Here’s the comparison, dimension by dimension.
| Dimension | Employed (W2) | Locum agency | Complete Endoscopy Care |
|---|---|---|---|
| Employment structure | W2 employee of the hospital | 1099 contractor through agency | 1099 to your own PLLC / S-corp |
| Who sets your schedule | Hospital admin | Agency picks placements | You do |
| Geography | Wherever you’re hired | Wherever the agency sends you | Drive-in or fly-in network — you pick |
| Patient continuity | Yes, your panel | No — revolving door, every 4–8 weeks | Yes — same hospital, same block |
| Pre-procedure clinic visits | Required | Sometimes | None — telehealth or APP |
| Call obligation | Often required | Sometimes negotiated | None |
| RVU / productivity targets | Yes | No (day rate) | No (day rate) |
| Documentation burden | Full EHR documentation, HEDIS measures, etc. | Lighter, varies | Procedure note only |
| Care team for intake, prep, path, follow-up | Hospital-dependent — often understaffed | None — you’re on your own | Built and running — same team every visit |
| Pre-credentialing | One site (your employer) | 30–120 days each new placement | Once — maintained for you across the network |
| Time from yes to first procedure | 6–12 month recruitment + start date | 30–120 days credentialing each cycle | 4–8 weeks per hospital, then permanent |
| Retirement contribution ceiling | ~$23K (W2 401(k) + match) | Limited — depends on your setup | Up to ~$70K (Solo 401(k) through your S-corp) |
| Business expense deductions | No (W2) | Limited | Yes — CME, mileage, equipment, home office |
| Markup taken from your bill rate | N/A | ~30% to the agency | None — direct contract |
| Time-off & sabbatical flexibility | Set PTO, often capped | Between placements only | You set it — ramp up or down between rotations |
| Equity in the practice you work in | No | No | Yes — PC shares accrue while under contract, recurring annual distributions, physician-owned cap table |
The honest summary: you leave the things that make employed GI unattractive (admin, RVU pressure, EHR theater) and the things that make locums GI unattractive (no continuity, agency markup, credentialing churn). This model is structured to remove both.
We don’t have a target persona. We have a model that flexes to match a few different career stages. If something below sounds like you, the model probably works.
You like procedures and dislike clinic. You’ve thought about going independent but the practice-build math is daunting. You want a real schedule and the financial upside of contractor status without the years of overhead.
You don’t need full-time income. You’d like to do procedures one week a month, see continuity patients, and stop existing in airports. Drive-in to a hospital within a couple hours of home is ideal.
School pickups, an aging parent, a partner with a non-portable career. Locum churn doesn’t work because it’s unpredictable; employed doesn’t work because the hours don’t bend. You want the same hospital block on the same week each month, near home.
You’ve given notice or are about to. You don’t want to jump to another W2 immediately and you don’t want to start a practice from scratch. You want predictable contractor income while you figure out what’s next.
Your employer is fine with your moonlighting (or you’re negotiating it). You want to build up an independent practice that lives in parallel for a year or two before you make a full transition.
Your home is in the Mid-Atlantic, in a town you don’t want to leave. The local hospital can’t fill GI. We can probably make that hospital one of your network sites and let you walk to work.
No. About half the people we talk to set theirs up after the conversation. Your accountant can do it in a week. Set-up cost is typically $300–800. We can recommend a few physician-friendly accountants if helpful.
Each contract you sign with CEC has an agreed scope at a hospital and the corresponding contract value. You’re paid the contract value in monthly installments to your business account — not per-procedure billing. Rates are transparent and consistent across the network; specifics walked through individually because they vary slightly by hospital scope and your malpractice election. Lifetime economics are competitive with mid-tier locum coverage without the agency markup, and the cash flow is far more predictable than per-block billing.
Yes, if your employment contract allows it (most do, with some restrictions). We’ll review your non-compete and moonlighting clauses before you commit. Many people start at 1 week/month while still employed, ramp to 2 weeks/month after 6–12 months, and either stay there or transition fully.
Fine. We need advance notice so the hospital block is covered by another doc in the network. As long as the schedule lock-in is respected, you can take meaningful breaks. This is one of the actual differences between this model and an employed role — nobody’s “FMLA-ing” you.
Three things. First, no agency markup — we’re not selling your time to the hospital, we have our own contracts. Second, you’re back at the same hospital every cycle, so patients see you. Third, the care team handles the wraparound work that locums don’t do, which is the only reason this is a viable service line for the hospitals in the first place.
We’ll review it. Most employed-GI non-competes have geographic radii that don’t cover rural hospitals 60+ miles outside metro areas. If yours does, we’ll talk through whether to wait it out or work in a different region first.
Your choice. Many physicians prefer to carry their own occurrence policy — deductible as a business expense, portable, multi-state coverage. Others prefer to use the CEC umbrella (factored into the contract rate). We talk through both based on your existing coverage and tail situation.
Yes, with notice. You might start at one hospital, like the model, and add a second the following quarter. Or decide a particular hospital’s a bad fit and swap it. Schedule changes are coordinated against the next rotation cycle so coverage is continuous.
None. The contracted scope is procedural endoscopy at scheduled blocks. ER consults, inpatient consults, GI bleeders — not in scope. The hospital handles its own emergencies through whatever existing coverage they had before us.
Modular up to 5 days/week. A 4-day or 5-day contract typically gets a higher fee from the hospital and proportional rate to you. Scope is negotiated per-hospital based on volume.
The network is being built — we’re in active conversation with rural and community hospitals across the Mid-Atlantic and Southeast. We’re happy to walk through the current pipeline and which hospitals are closest to your geography.
Each contract you hold with CEC accrues shares in the state-level PC — the physician-owned practice entity. Shares are granted quarterly while the contract is active, scaled to contract scope. Two-year vest with a one-year cliff. The PC distributes its annual profit to shareholders pro-rata to vested shares, year over year. 100% of PC equity is held by participating physicians; no outside investors on this cap table. As more docs join, your stake dilutes proportionally, but the pool stays physician-owned by definition. Per-share grant rate per contract scope, current PC valuation, and buy-back terms are walked through individually before any contract signing — we’re not committing to specific numbers on a webpage.
The practice. CEC has two entities: the PC (Professional Corporation) which is the physician-owned clinical practice, and the MSO (Management Services Organization) which is the non-clinical operating company — platform, care team, hospital contracts, investor capital. Participating physicians earn shares in the PC, not the MSO. This keeps physicians on a clean physician-only cap table and aligns governance over clinical decisions with the people doing clinical work. The MSO is run separately by the operating-company founders.
We’re an independent, founder-led operating company — not a PE roll-up. We don’t buy practices and we don’t replace docs with mid-levels. The model is a managed service line with a per-contract economic structure (similar in shape to managed anesthesia or managed hospitalist programs). The PC, where physicians hold equity, is structurally separate from the MSO and stays physician-owned. Happy to walk through both cap tables in a conversation if that’s relevant to you.
No application portal. No HR. Send an email and we’ll set up a 30-minute call — cover what regions are active, what your scope and geography preferences are, and what the math works out to in your situation. If it’s a fit, we keep talking. If it’s not, you’ve learned something useful about an emerging model.
Send an email More questions first