All moves, med school to late career · Early career · Mid career · reviewed October 27, 2026 · oldest source check October 21, 2026
The decision. A partnership vote and buy-in, or an offer to buy the practice from a hospital, a corporate buyer or a private-equity firm.
What changes
- 82.0% of physicians were employed by hospitals, health systems or corporate entities on January 1, 2026, and 63.9% of practices were owned by them.PAI-Avalere, Physician Employment Trends and Practice Acquisitions 2018–2026 · checked October 21, 2026
- In the AMA's Physician Practice Benchmark Survey, the share of physicians in private practice fell from 46.7% in 2022 to 42.2% in 2024, and the share in private-equity-owned practices rose from 4.5% to 6.5%.AMA, Physician Practice Characteristics in 2024 · checked October 21, 2026
- Studies of Medicare billing data found more physicians leaving after private-equity deals. In 200 ophthalmology practices acquired from 2014 to 2021, physician exits rose 13 percentage points. When a private-equity owner later sold a practice, its physicians were 16.5 points less likely to still work there two years on. Billing data do not show which physicians were owners, so neither study separates owners from associates.Singh et al., Health Affairs 2025;44(3):280, physician exits after PE acquisition (ophthalmology); Berquist, Klarnet and Dafny, JAMA Health Forum 2025, physicians after PE exits · checked October 27, 2026
Not measured.
- No source in Andwise's research measures how long partnership tracks run, or how often a track ends without a vote.
Who is paid for what
How each party at this decision is paid, and what its role does not include. The page states payment structures only, not intentions.
The existing partners
No published source recorded yet.
Not part of its role Valuing the practice on the incoming physician's behalf.
A private-equity buyer
No published source recorded yet.
Not part of its role Explaining what a sale does to an associate's partnership track.
Costs that come later
What is agreed at this decision, and when its cost arrives.
- The buy-in price and how it is financedLands at The years after the vote, as the partner income difference repays itPartnership buy-in arithmetic
- Non-competes in the purchase, employment and equity agreementsLands at Leaving the practice after a saleNon-compete laws by state
Deadlines, and who sets them
- Set in the contractThe partnership vote
- Set by the other partyA buyer's offer window
Tools, in the order this decision uses them
Partnership buy-in arithmetic
Months to recoup the price, financing interest, and the share implied by head count.
What changed in a renewal contract
The employment agreement before and after a sale, clause by clause.
Non-compete laws by state
Each state's rule, with citations.
Questions for a professional or the other party
Counsel
- Which agreements carry a non-compete: the purchase agreement, the employment agreement, an equity agreement?
- What happens to the partnership track if the practice is sold before the vote?
The practice's valuer or a CPA
- How was the buy-in price calculated, and what does it include: hard assets, receivables, goodwill?
- How is the buy-in financed, and how is each part taxed?
Andwise computes the buy-in arithmetic and quotes the agreements. It does not value a practice or say whether a buy-in or a sale price is fair; that is a valuer's and counsel's work.