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Goal: more clinical capacity without giving away equity you’ll regret, or withholding it until your best clinician leaves to compete with you.

Associates: the employment questions

  • Compensation model. Base salary, percentage of production or collections, or hybrid with a draw. Note the difference: a percentage of collections makes the associate share your payer-collection reality; a percentage of production doesn’t. Use specialty compensation surveys, not guesswork.
  • The credentialing lead time. An associate can’t bill payers until credentialed: 90 to 180 days. Sign offers accordingly and plan the gap consciously.
  • Restrictive covenants. Clinician non-competes are state-dependent and shifting. Several states now restrict physician non-competes outright. Draft with current local counsel.
  • Malpractice. Occurrence vs. claims-made, and who pays tail coverage on departure. Decide it in the offer letter, not the exit interview.
  • Classification. A full-schedule associate is an employee under any honest test. Misclassification is actively enforced.

Partners: the equity questions

  • Agree the valuation method in writing before emotions attach to a number.
  • Practice lenders finance buy-ins. Earn-ins need documented milestones or they get litigated.
  • Keep production pay separate from ownership returns. Equal profit splits with unequal production is the classic partnership resentment.
  • The buy-sell agreement is the whole game. Write it while everyone likes each other.
  • Licensing constraint: in most states only same-licensed professionals can own the PC (CPOM). A non-clinician “partner” can’t hold PC equity. That road leads to the MSO structure.

The banking corollary

Partners mean shared control of money, so controls stop being optional: dual approval over thresholds, role-based access, clean distribution mechanics, and reporting both partners actually see (banking structure). Many partnership disputes are, at bottom, information asymmetry about the bank account. Fix it with permissions, not lawyers.