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Medisch specialisten zijn curieuze ondernemers. Kenmerken van ondernemerschap zijn innovatie en risico’s nemen voor eigen rekening. In goede tijden of bij succesvolle keuzes profiteert de ondernemer, in slechte tijden moet hij of zij bloeden. Sinds de integrale bekostiging is ingevoerd, mogen medisch specialisten kiezen tussen diverse vormen van relaties met het ziekenhuis.