Don't know the answer to that one but if you're saying that Canadian doctors are you're wrong. They operate their own private practices , keep their own hours , pay their own staff and aren't on salary . Contrary to some posts I've read on FR they're not on any kind of quota either.
Shouldice Clinic is a privately owned clinic that has developed special procedures to deal with all types of hernias . My wife's uncle had a double hernia repaired there last fall ( he paid for his stay, about $800 , OHIP the rest ) . IIRC , from their web site , about a third of their patients are American .
They may have their own offices but there are other issues they have to deal with. No quotas per se but in Ontario there is an annual cap on the amount that they can bill the system, which is why it's almost impossible to get an appointment in December (most close their offices when they max out). Also, the NDP has long advocated turning doctors into salaried employees.