This advice given to Nurse Practitioners might apply to many other professions seeking ways to create an independent business model:

"If all of this is daunting, keep in mind these three things. First, some of the most successful restaurants started out as small catering businesses. Second, whether you are going for a change of law or a contract with a practice or managed care company, it pays to be a good negotiator. Third, if a service is good and needed, usually there is a way to make a business out of it."

This is from the article, "In search of independent NP practice", written by Carolyn Buppert, CRNP, JD, in the journal: Journal for Nurse Practitioners. 2007;3(6):374-376.