I would echo Adam. Having been in an essentially identical situation about 12 years ago (too busy, unforgiving administration, burned out, threats of trying to enforce noncompete) I found a good counselor/business consultant (fortunately was the same person who I still meet with monthly 11 years later) to take care of the most important issue (you). I ended up not wanting to go through the process of fighting a noncompete and simply did a 'fill in position' for a year more than the 20 miles away. I was also told that my noncompete started when my contract ended...not when I left. A dubious claim, but one that I did not have the energy to fight. (Noncompetes in healthcare are now illegal in NH!) I had been in town for some time, so had a following. That gave me the year to decompress, and do a lot of thinking about how I wanted to practice (remember...you are the expert) then set up a business model that worked based on what we felt we should really be doing as primary care docs.Working through a business proforma... I was a amazed by the amount of overhead waste large organizations promulgate. I was pleased to find many folks very willing to help...accountant, reps from McKesson, insurance folks, even patients etc...
We started with Soapware (now defunct) then went with Athena.
We did not do MU/Macra/MIPS and are happy we did not (although it looks like it would be very easy with Athena).
We do 'request' (not required) a $130 (started at $100 in 2007) once per year 'noncovered services fee' from all adult patients...which has really made a big difference....we also opted out of Medicare (at that time it made sense). But I would submit that every IMP does things a bit differently..and successfully.
I essentially asked myself when working for the hospital....could I see myself doing this for the next 20 years....the answer was clearly no. Sounds like you are in the same place. I knew I could always get a 'standard job' as an FP in some 'system' if I needed to, but wanted to give it another shot (I had run my own practice before selling it to the hospital in the mid 90s). I too..did not want to move. I could not be happier. We have been able to stay in our home town....put our kids through college and (maybe) retire someday...but to tell the truth, I am thinking I really do not want to retire anytime soon if professional life continues to be so good. I also have much better 'work life' balance...although you do need to have some 'small business excites me' in you. When we set up the practice...the first thing our 'business consultant' said was 'stop thinking like a doctor for this part'. Good advice.
We came back and put up our shingle after being out of practice in our town for one year and a day....no problem attracting patients, even after a year 'away'. There are some things we did that helped this...and would be glad to chat about these, as they say...all healthcare is local and everyone's circumstances are different. Chatting a bit with Adam or Jean or any other the other IMPs may be very useful.