Physician contract trends: What to know before you recruit another doctor

For practice administrators, physician employment contracts are no longer boilerplate. The agreements themselves, and the ownership transitions behind them, have grown more complex as private equity and larger institutions reshape the industry, said two attorneys who represent physicians nationally.

Nick R. Masino, Esq., and Mark D. Abruzzo, Esq., partners at the Pennsylvania-based firm Wade, Goldstein, Landau & Abruzzo, P.C., represent physicians, physician-owned groups and other health care providers on corporate and transactional matters. Masino, who has practiced law since 2011, and Abruzzo, who has represented physicians since the mid-1980s, discussed how administrators can help their organizations navigate contracting, compensation and succession planning. Masino and the firm's vice president, Robert J. Landau, are scheduled to present "Buy-Ins, Buy-Outs, and Leadership Risk" at the Medical Group Management Association's fall 2026 conference. The attorneys met online with Physicians Practice ahead of the meeting.

They said administrators should watch state-level shifts on noncompete enforcement closely, because more states are banning or limiting these clauses for physicians, which can require updating existing contracts or notifying staff. They also pointed to practical contract details administrators help manage day to day, including termination and notice periods, repayment terms tied to signing bonuses and relocation packages that can run into six figures, and tail insurance coverage.

Masino and Abruzzo said succession planning looks very different depending on practice size. Larger, corporate-owned groups typically have more established processes, they said, while small independent practices without a clear successor can be forced into a distressed sale. The attorneys also discussed how private equity has pushed many practices toward more standardized compensation structures and new forms of physician ownership, such as profit interest units.