Group Practice with Neal Goldstein

Neal Goldstein · goldsteingrouppractice.com

Group Practice with Neal Goldstein is a podcast providing insights on law, business, and physician group practices. Each episode provides valuable information on successful legal structures and strategies for physician groups, while also occasionally featuring physician leaders and other healthcare and business leaders who have built and maintained successful organizations. If you’re a private practice physician group leader, this is the show for you.

27 episodes

12d ago latest

weekly cadence

English language

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Episodes 28

Wind-Down Before Redemption: A Sound Approach for the Physician and the Group
5d ago · 14:51
Transitioning from sixty to zero miles an hour is dangerous for retiring doctors and bad business for medical group practices. Host Neal Goldstein explains the critical concept of physician wind down status. This strategy allows senior partners to reduce their clinical and administrative burdens while paving the way for younger talent to ascend within the organization. Group leaders and retiring practitioners will discover how to create a smooth exit transition that benefits the entire practice. What you will learn: ● Why the traditional partnership mentality fails for physically demanding med
The Art of the Physician Buyout
12d ago · 25:12
Retiring from a medical group does not guarantee a massive payout. If you breach your non-compete, you could lose everything. Neal Goldstein breaks down the financial realities of partner redemptions in medical group practices. This breakdown reveals how to fairly value hard assets and accounts receivable while protecting the practice from bad leavers. It is essential listening for any physician navigating a buyout or succession plan. What you will learn: ● Buyout prices should equal the initial buy-in amount to maintain parity. ● Hard asset payouts should mirror the buy-in structure and be pa
A Pod on Redemption
19d ago · 17:51
Forcing a medical partner to sell their shares feels brutal, but failing to do it can destroy your entire group practice. Neal Goldstein reveals the complex realities of partner redemptions in medical groups. This discussion breaks down why mandatory buyouts are actually essential for succession planning and how to protect your organization from legal friction. If you run a group practice or plan to become a partner, this is required listening. What you will learn: ● The critical difference between voluntary departures and mandatory partner redemptions. ● Why productivity-based buyouts are rar
The False Comfort of Federal Carveouts
26d ago · 20:45
Medical practices think shielding Medicare patients from private deals keeps them safe from fraud laws. That false comfort can ruin your medical career. Healthcare attorney Neal Goldstein breaks down the dangerous reality of federal carve-outs in medical contracts. This breakdown reveals how state laws and hidden kickback definitions trap unsuspecting doctors. It is essential listening for practice owners and healthcare administrators looking to protect their clinics. What you will learn: ● The actual definition of a federal carve-out and why it creates a false sense of security for physicians
Michael Kroin of Physician Growth Partners: Key Considerations When Selling to Private Equity
1mo ago · 44:48
Selling your medical practice is the biggest financial decision of your life, but going into negotiations without an expert is a massive mistake. Michael Kroin is the co-founder of Physician Growth Partners, an investment banking firm specializing in healthcare transactions. He breaks down why independent physicians need a specialized team to navigate the complex world of private equity buyouts, hospital consolidation, and payer pressure. If you are a doctor weighing the future of your independent group, this breakdown of the current market will help you decide if selling is your best strategi
Contractual Indemnities
1mo ago · 18:46
A single buried sentence in your hospital agreement could expose you to unlimited personal liability that your insurance absolutely refuses to cover. Neal Goldstein reveals the immense financial dangers of contractual indemnity provisions found inside professional services agreements. This critical discussion breaks down why deep-pocketed hospitals shift their legal risk onto doctors and exactly how group practices can protect their personal assets. If you sign physician contracts, you must understand this devastating exclusion. What you will learn: ● Why standard medical malpractice insurance
ASC Strategies For The Group Practice
1mo ago · 32:14
To survive in independent medicine, you must control where the surgery happens. But partnering with a hospital might be your biggest mistake. Neal Goldstein breaks down exactly why medical group practices need to own their Ambulatory Surgery Centers (ASCs). He reveals why controlling the site of service protects your revenue, why single-specialty centers outperform multi-specialty ones, and how to navigate Certificate of Need (CON) laws without surrendering control to hospital systems. What you will learn: ● Why controlling the site of service is the ultimate key to surviving as an independent
Peter Cunningham of Evolve Healthcare Marketing: Adding Science to the Art of Medical Group Marketing
1mo ago · 34:59
Half of all advertising spend is wasted—and in healthcare, your front desk intake might be the biggest leak destroying your patient growth. Peter Cunningham is a three-time entrepreneur and the founder of Evolve Healthcare Marketing, a digital agency specializing in private physician groups and provider organizations. In this conversation with host Neal Goldstein, Peter reveals why traditional medical marketing fails, how recent Google health ad policy crackdowns impact patient acquisition, and how independent practices can thrive against hospital systems. This episode is essential for practic
Competing with the Hospital Employed Group
2mo ago · 33:19
The report of the private medical practice’s death has been greatly exaggerated. Here is exactly how independent doctors are beating hospital systems. Neal Goldstein draws on over 30 years of experience to reveal why private medical practices still hold the upper hand against well-capitalized hospital-employed groups. This episode is a strategic playbook for independent physicians looking to stop playing defense and start leveraging their true competitive advantages. What you will learn: ● Why the massive bureaucracy of hospital scheduling creates a patient access advantage for independent cli
Buy-In of Partner: Admission of an employed doctor to partner.
2mo ago · 28:38
A massive partnership buy-in might make founders rich today, but it could permanently destroy the medical practice’s future growth. Neal Goldstein breaks down the financial realities and mechanics of admitting an employed doctor as a partner into a medical group. This episode explores how medical groups structure partnership buy-ins, the components of a fair deal, and why traditional valuation models often fail in the healthcare space. Whether you are a founder looking to expand or a young doctor navigating a partnership offer, this outlines exactly how the money should work. What you will lea
Partner Admission: Admitting an employed physician into partnership
2mo ago · 21:53
Most medical groups assume new partners must buy into the practice’s real estate, but that expectation might be turning away top doctors. Neal Goldstein breaks down the complexities of admitting an employed physician into partnership at a medical group practice. This episode explores the exact timeline, criteria, and ancillary venture rules you need to structure a safe and profitable partner admission. What you will learn: ● The eligibility period for partnership depends heavily on market dynamics and the size of the buy-in amount. ● A doctor’s productivity and clinical quality serve as the ba
How to Survive the Rollercoaster of a Malpractice Lawsuit with Bill Rogers
2mo ago · 36:45
Most doctors think a malpractice lawsuit will ruin their life. But the truth is, you are statistically more likely to win than lose. Bill Rogers is a veteran medical malpractice defense lawyer and partner at Swanson, Martin and Bell in Chicago. In this episode, he breaks down the reality of facing a lawsuit, the emotional toll it takes on physicians, and the strategic secrets to winning in front of a jury. What you will learn: ● Why doctors actually win 65 to 75 percent of medical malpractice jury trials in Cook County. ● The predictable emotional rollercoaster every first-time defendant exper
Professional Risk Management
2mo ago · 27:48
The litigation tracker template built by expert group practice consultants is the single most effective tool for lowering medical malpractice payouts. In this episode, veteran practice advisor Neal Goldstein breaks down the operational blueprint for running an active, proactive professional risk management program. Discover how medical groups can leverage clinical data, maintain strict defense postures, and audit insurance carriers to institutionalize quality improvement across their entire organization. What you will learn: ● Why treating risk management as a proactive business strategy direc
A Medical Group is a Business Arrangement
3mo ago · 12:22
Most healthcare leaders treat medical groups like clinical entities. Legal and financial experts know they are actually structured as business arrangements. Neil Goldstein breaks down the operational paradigm of physician group ownership. Learn how the separation of clinical functions from business structures allows healthcare practices to maximize operational efficiency and growth under modern regulatory frameworks. What you will learn: ● Why ancient laws governing fee splitting and corporate medicine force unique legal structures on private equity groups ● The critical operational difference
Fee Splitting/Corporate Practice of Medicine Laws, and the Business of Healthcare
3mo ago · 26:27
Most healthcare founders think corporate ownership of medical practices is strictly illegal. The truth is much more complex. Healthcare attorney Neal Goldstein breaks open the state-level laws governing Fee Splitting and the Corporate Practice of Medicine (CPM). In this episode, he strips away the legal fluff to reveal the exact structural workarounds private equity firms use to acquire, manage, and scale medical groups across the United States. If you are trying to understand how modern medical groups are actually financed and structured, this breakdown is for you. What you will learn: ● Why
Beyond CPAP: How ENT Dr. Len Covello Is Rethinking Sleep Apnea Care
3mo ago · 39:56
Most sleep specialists are just CPAP purveyors. If the mask fails you, they often have no next step. Dr. Len Covello is changing that narrative. Neal Goldstein sits down with Dr. Len Covello, an otolaryngologist and sleep surgery innovator who developed the sleep surgical program at Powers Health. This episode cracks open the “system failure” in sleep medicine and provides a holistic roadmap for those failing traditional treatments. What you will learn ● Why the “CPAP or bust” mentality creates a massive blind spot in modern sleep medicine ● The mechanics of Hypoglossal Nerve Stimulation and w
Sale to PE: The Two Hats a Selling Physician Wears
4mo ago · 22:34
In this episode, Neal Goldstein breaks down the “two hats” physicians wear in private equity transactions: seller and rollover owner/employee. He explains that while most physicians focus heavily on upfront cash, indemnities, and non-competes in the sale, they often don’t pay as much attention to equally critical employment and rollover equity agreements. Neal highlights why it is important to focus on rollover and employment terms. Rollover equity can represent a substantial portion of total deal value, and its terms—vesting, forfeiture, buyback rights, and valuation—vary widely and directly
Being Strategic: Lessons from the PE Firms
4mo ago · 25:33
In this episode of Group Practice, host Neal Goldstein discusses why private equity (PE) firms are often able to operate more strategically than independent physician groups—and how those groups can adopt similar approaches without selling. Drawing on his experience, Neal explains that PE firms benefit from centralized decision-making, clear performance metrics like EBITDA, and shorter investment horizons that drive disciplined execution. Neal highlights four areas where he sees PE firms create value: physician staffing (particularly succession planning and strategic hiring), expense managemen
Back to Non-Competes: Addressing Listener Feedback
4mo ago · 30:31
In this follow-up episode of Group Practice, host Neal Goldstein addresses listener feedback about non-competes in physician practices. He tackles three key questions: Are non-competes ever appropriate? What’s the point of enforcing them if they’re often struck down? And what alternatives exist? Neal argues non-competes remain appropriate in several contexts: competing against hospital systems, PE-backed practice sales, groups with exclusive hospital contracts, and specialties with high capital costs. He emphasizes that despite headlines suggesting otherwise, non-competes are still being enfor
The Future of Podiatry Practice: From Solo to Platform – with Dr. Lowell Weil of Balance Health
4mo ago · 48:44
In this episode of Group Practice, host Neal Goldstein interviews Dr. Lowell Weil, Executive Chairman of Balance Health and formerly the CEO of Weil Foot & Ankle Institute a 53-physician podiatry group founded by his father Dr. Lowell Weil Sr. Dr. Weil discusses the five practice settings for podiatrists: solo/small practices, orthopedic groups, hospital systems, large independent groups, and platform-backed groups like Balance Health. Dr. Weil highlights the mounting challenges facing small practices – stagnant Medicare reimbursement, rising costs, and physician burnout – and explains how Bal
Discussion with PFS Labor & Employment Practice Chair, Nora Walsh, on the Evolving Law of Non-Competes
5mo ago · 30:40
In this episode of Group Practice, host Neal Goldstein welcomes his partner, and leader of PFS’s labor and employment practice, Nora Walsh, for a deep dive into the evolving world of physician non-competes. They explore the common law foundations – reasonableness in time and geography, and protectable interests – and how Illinois’s landmark Fifield case added consideration requirements, later codified in the Freedom to Work Act. The conversation surveys the national landscape: outright bans in California, Minnesota, and others; Texas’s practical buyout approach; Florida’s employer-friendly sta
Overview of the Anti-Kickback Statute
5mo ago · 22:10
This episode of Group Practice with Neal Goldstein provides an overview of the Anti-Kickback Statute (AKS), a federal fraud and abuse law enacted in 1972 that applies to all federal healthcare programs. Unlike the Stark Law, AKS is an intent-based statute that prohibits knowingly giving or receiving remuneration to induce referrals for federally reimbursable healthcare items or services. The landmark United States v. Greber case established the “one purpose test”— if even one purpose of payment is to induce referrals, the statute is violated. Due to this broad interpretation, safe harbor regul
Discussion with Dr. Richard Harris, national leader in urology and CEO of Uropartners
5mo ago · 38:45
In this episode of Group Practice, Neal Goldstein interviews Dr. Richard Harris, founding member and longtime CEO of Uropartners, about building one of the nation’s premier independent urology groups and the leadership principles behind its success. Dr. Harris recounts the challenging two-year process of merging 11 competing practices into a unified organization—overcoming distrust, strong personalities, and the independent nature of physicians. He discusses Uropartners’ strategic growth through high-quality ancillary services, including a centralized pathology lab, a dedicated urology surgery
Stark Law Explained
5mo ago · 18:15
In this episode of Group Practice, host Neal Goldstein explains the federal Stark Law, the prohibition on physician self-referrals, one of the two major healthcare fraud and abuse laws governing physicians. He describes Stark as a complicated but important statute enacted in 1989 and expanded in 1993 to cover ten “designated health services” (DHS), including imaging, physical therapy, durable medical equipment, and hospital services. Neal emphasizes that Stark is technically a Medicare and Medicaid payment law, but it functions like a fraud and abuse statute because violations require repaymen
Physician Group Consolidation
6mo ago · 19:23
In this episode of Group Practice, Neal Goldstein explores the business case for physician group consolidation, distinguishing it from mere aggregation. True consolidation, he explains, involves full integration into a unified group practice—legally and operationally—rather than loosely affiliated practices sharing ancillaries. Neal outlines five primary advantages: (1) central business office efficiencies, allowing groups to hire specialized expertise in billing, revenue cycle, and managed care contracting; (2) increased negotiating leverage with insurers, hospitals, and vendors; (3) enhanced

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Group Practice with Neal Goldstein

Episodes 28

Wind-Down Before Redemption: A Sound Approach for the Physician and the Group

The Art of the Physician Buyout

A Pod on Redemption

The False Comfort of Federal Carveouts

Michael Kroin of Physician Growth Partners: Key Considerations When Selling to Private Equity

Contractual Indemnities

ASC Strategies For The Group Practice

Peter Cunningham of Evolve Healthcare Marketing: Adding Science to the Art of Medical Group Marketing

Competing with the Hospital Employed Group

Buy-In of Partner: Admission of an employed doctor to partner.

Partner Admission: Admitting an employed physician into partnership

How to Survive the Rollercoaster of a Malpractice Lawsuit with Bill Rogers

Professional Risk Management

A Medical Group is a Business Arrangement

Fee Splitting/Corporate Practice of Medicine Laws, and the Business of Healthcare

Beyond CPAP: How ENT Dr. Len Covello Is Rethinking Sleep Apnea Care

Sale to PE: The Two Hats a Selling Physician Wears

Being Strategic: Lessons from the PE Firms

Back to Non-Competes: Addressing Listener Feedback

The Future of Podiatry Practice: From Solo to Platform – with Dr. Lowell Weil of Balance Health

Discussion with PFS Labor & Employment Practice Chair, Nora Walsh, on the Evolving Law of Non-Competes

Overview of the Anti-Kickback Statute

Discussion with Dr. Richard Harris, national leader in urology and CEO of Uropartners

Stark Law Explained

Physician Group Consolidation

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Episodes 28

Wind-Down Before Redemption: A Sound Approach for the Physician and the Group

The Art of the Physician Buyout

A Pod on Redemption

The False Comfort of Federal Carveouts

Michael Kroin of Physician Growth Partners: Key Considerations When Selling to Private Equity

Contractual Indemnities

ASC Strategies For The Group Practice

Peter Cunningham of Evolve Healthcare Marketing: Adding Science to the Art of Medical Group Marketing

Competing with the Hospital Employed Group

Buy-In of Partner: Admission of an employed doctor to partner.

Partner Admission: Admitting an employed physician into partnership

How to Survive the Rollercoaster of a Malpractice Lawsuit with Bill Rogers

Professional Risk Management

A Medical Group is a Business Arrangement

Fee Splitting/Corporate Practice of Medicine Laws, and the Business of Healthcare

Beyond CPAP: How ENT Dr. Len Covello Is Rethinking Sleep Apnea Care

Sale to PE: The Two Hats a Selling Physician Wears

Being Strategic: Lessons from the PE Firms

Back to Non-Competes: Addressing Listener Feedback

The Future of Podiatry Practice: From Solo to Platform – with Dr. Lowell Weil of Balance Health

Discussion with PFS Labor & Employment Practice Chair, Nora Walsh, on the Evolving Law of Non-Competes

Overview of the Anti-Kickback Statute

Discussion with Dr. Richard Harris, national leader in urology and CEO of Uropartners

Stark Law Explained

Physician Group Consolidation