The American Association of Medical Colleges’ seventh annual report on physician workforce projections calculates two out of every five practicing physicians will turn 65 in the next two years.1 The combination of an aging physician population and burnout that was escalating even before the stressors of COVID-19 has been a catalyst for physicians retiring and selling their practices to others to facilitate their exit strategies. Additional stressors included ever-lowering reimbursement rates, ever-rising expenses, and difficulty getting paid by payers. One option many plastic surgery, and some dermatology and ophthalmology, practices have exercised is the calculated and strategic decision to discontinue taking insurance (often including Medicare) reimbursement. Practices changing to a fee-for-service model usually already have significant and profitable elective service lines.