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My BIL is an ER doc and he's facing this exact scenario by 105Marquette

Almost verbatim. He works for a partnership of ER docs that's negotiating their next contract with the hospital they provide services to. The hospital wants to cut rates (of course) and has this partnership basically unable to take their services to another hospital. Its at the point where he and my sister are considering an out of state move from the Boston burbs.