For Physicians

The Patient Physician Relationship Is Under Pressure.

Independent practices are contracting. Reimbursements have not kept pace with the cost of delivering care. Physicians are increasingly asked to do more with less time, less ownership, and less voice in how medicine is practiced.

The numbers are unambiguous. According to the American Medical Association, Medicare physician payment has declined 29% in real terms since 2001, adjusted for practice cost inflation. The Medicare Conversion Factor, the dollar amount used to calculate physician reimbursement, was $31.00 in 1992. In 2025, it stands at $32.36. Adjusted for inflation, it should exceed $70.00 today. Year after year, physicians are effectively paid less for the same clinical work, even as the costs of staff, technology, malpractice, and compliance continue to rise.

Meanwhile, hospitals benefit from site of service payment advantages and steady CMS increases. Private equity firms acquire practices at distressed valuations. Insurers delay or deny payment. The result is a profession where those actually delivering care are systematically devalued.

The administrative burden compounds the financial one. AMA surveys indicate physicians now spend more than 15 hours per week on prior authorizations alone. Nearly 60% report symptoms of emotional exhaustion. These are not conditions of a profession in equilibrium.

Selkirk Center exists as a structural alternative. Not a surgery center, not a staffing arrangement. A physician led hospital where physicians are owners, equity holders, and governors of the institution they practice in. The clinical model, the protocols, the technology choices, the culture — set by the people delivering the care, not a corporate parent three layers removed from the patient.

What Selkirk Offers.

• Equity and ownership. Physicians invest in and own the hospital, building long term wealth alongside the institution's growth, and holding governance authority that employment models cannot offer.
• Autonomy over the clinical environment. Protocols, technology choices, and institutional priorities are set by the physician owners, not a corporate parent or health system administrator.
• Ownership as an offset to reimbursement compression. As Medicare and commercial reimbursement continue their long term compression, institutional ownership provides an alternative economic structure for long term physician financial health.
• A focused, purpose built facility. Selkirk Center is not a converted wing or a leased suite in a system hospital. It is a purpose built specialty campus, designed from the ground up around physician governance and clinical efficiency.
• North Idaho's growth trajectory. Rathdrum and Kootenai County represent one of the fastest growing markets in the Pacific Northwest. The region's population growth has outpaced its healthcare infrastructure across virtually every specialty. The demand is documented and the market is underserved.

All physician conversations are confidential. Equity structure, compensation, and clinical role are discussed directly with qualified candidates. No commitment is required to have an initial conversation.

Physicians Who Want to Own Where They Practice.

Selkirk Center is recruiting physicians across surgical and clinical specialties. If you are currently employed by a health system, an academic medical center, or a private equity backed practice — and you have considered what it would mean to own the institution you practice in — we want to have that conversation.

We are not prescriptive about specialty. The governance model, the equity structure, and the clinical philosophy apply regardless of what you practice. The conversation starts with alignment on ownership, autonomy, and long term vision. Everything else follows from there.

All conversations are confidential. No commitment is required to explore whether Selkirk Center is the right fit.