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Market leader Atrium Health is planning to merge with Georgia-based Navicent Health in a deal that would give rise to a regional integrated delivery network, strengthening Atrium Health’s clout and control over market dynamics in Charlotte. Ahead of the proposed merger, about 90 physicians have decided to leave one of Atrium Health’s largest physician practices to form an independent practice, bucking the national trend toward hospital and physician integration. But for most physicians in the Charlotte market, where hospital and physician group deals dominate the provider landscape, integration with health systems continues to hold opportunities. As clinically integrated networks become the norm locally, pharmaceutical representatives will continue to face challenges reaching physicians.