Group Practice with Neal Goldstein

Neal Goldstein
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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.

  1. hace 1 día

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

    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 practice administrators, private equity investors, and independent physicians looking to scale measurable, reliable patient growth. What you will learn: ● Why marketing a medical practice like a standard retail or home services business leads to compliance failures and wasted ad spend ● The “Three Legs of the Stool” framework: how performance marketing, intake operations, and decision support must work together for patient growth ● Why front-desk intake operations and unanswered inquiries represent the single biggest financial leak in healthcare marketing ● How integrating marketing dashboards with EMR and financial systems allows practices to track ROI down to the exact insurance copay collected ● The “Poet vs. The Engineer” philosophy: why mid-market healthcare groups must prioritize quantitative performance and “butts in seats” over creative brand awards ● How retired physicians using peer-to-peer cold calling achieve a staggering 96% appointment booking rate with practice decision-makers ● Why hospital consolidation and post-COVID restrictions have permanently killed traditional “bagel drop” physician referral networks ● Why independent practices have a major tactical advantage over hospital-employed groups because patients actively avoid “big box medicine” Timestamps: 00:00 — Healthcare Digital Marketing and Agency Accountability 01:33 — Why Medical Marketing Is Different: HIPAA and Health Ad Policies 06:27 — Evolve’s Three-Legged Stool: Performance, Intake, and Data 07:35 — Why Front-Desk Intake Is the Biggest Marketing Leak 08:07 — Revenue IQ: Tracking ROI from Ad Click to EMR Billing 14:11 — B2B Telemarketing: Why Retired Physicians Achieve 96% Booking Rates 16:47 — The Poet vs. The Engineer: Brand Marketing vs. Performance Marketing 23:05 — Competing With Hospitals: The Future of Independent Medical Practice 27:36 — Why Traditional Physician Referral Networks Are Dead 30:19 — Why Patients Avoid “Big Box Medicine” and Choose Private Practices Peter Cunningham is a three-time business owner and the founder of Evolve Healthcare Marketing, a specialized digital agency that helps mid-market and enterprise-level provider organizations grow. Combining deep healthcare compliance expertise with predictive data analytics, his agency acts as an outsourced chief marketing officer for private practices and private equity-backed healthcare businesses. He is dedicated to replacing agency guesswork with transparent, quantitative decision support that tracks patient acquisition from initial click to final billing. Website: ehmresults.com LinkedIn: /in/evolvehealthcaremarketingpsc Facebook: evolvehealthcaremarketing Show subscribe and platform links New episodes every week — subscribe so you never miss a conversation on the business of medicine. Spotify | Apple Podcasts | YouTube Disclaimer This episode is for informational and educational purposes only and does not constitute legal, financial, or medical advice. #HealthcareMarketing #MedicalPractice #DigitalMarketing #PracticeManagement #PhysicianGroup #PrivatePractice #HealthcareROI #MedicalAdvertising #EvolveHealthcare #GroupPracticePodcast

    35 min

  2. 30 jun

    Competing with the Hospital Employed Group

    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 clinics. ● How private practices can use ancillary profit-sharing to compete with inflated hospital compensation offers. ● The hidden reason why high-deductible insurance plans are driving patients away from hospitals and toward independent doctors. ● Why hospital brands suffer from “dilution” while focused private practices build stronger, localized authority. ● How to pitch independent practice solutions directly to the hospital C-suite to solve problems their employed groups cannot Timestamps: 00:00 — The Demise of Private Practice is Exaggerated 00:52 — Advantages of Private Practice vs. Hospitals 03:40 — How Hospitals Control Primary Care Referrals 04:23 — Winning on Patient Access and Experience 08:44 — Competing with Hospital Physician Compensation 12:59 — Hospital Bureaucracy vs. Private Practice Agility 17:53 — Why Less Expensive Private Care Wins Patients 21:40 — Hospital Marketing Budgets vs. Focused Branding 25:57 — Playing Offense: Partnering with the Hospital Neal Goldstein is an experienced healthcare attorney, legal strategist, and board member specializing in medical practice structures. He served as the structural engineer for the founding of the Illinois Bone and Joint Institute and has provided guidance on healthcare governance through his work on hospital system boards. His work focuses on navigating the Stark Law, corporate practice of medicine doctrines, and professional risk management Website: https://www.pfs-law.com/ Website: https://www.goldsteingrouppractice.com/ Website: https://nealtgoldstein.com/ LinkedIn: https://www.linkedin.com/in/neal-t-goldstein-841aa652/ Show subscribe and platform links New episodes every week — subscribe so you never miss a conversation on the business of medicine. Spotify | Apple Podcasts | YouTube Disclaimer This episode is for informational and educational purposes only and does not constitute legal, financial, or medical advice. #PrivatePractice #MedicalBusiness #HealthcareAdministration #PhysicianOwned #HospitalSystem #MedicalGroup #PracticeManagement #GroupPractice

    33 min

  3. 23 jun

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

    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 learn: ● The exact differences between hard asset, accounts receivable, and goodwill buy-ins. ● Why requiring new doctors to buy into their own generated receivables is financially fair but psychologically controversial. ● How to shift accounts receivable buy-ins into pre-tax income to save new partners money over a two-to-three-year period. ● Why using private equity EBITDA multiples to value traditional physician groups usually fails. ● The Path to Parity model that scales an employed doctor’s profit share incrementally over five years. ● Why the concept of a standard buy-in formula for your specific region or specialty is usually a complete myth. ● How one Midwest medical group used a shockingly low $20,000 buy-in to drive massive practice growth and recruit top talent. Timestamps: 00:00 — The Financial Aspects of Medical Partnership Buy-Ins 01:00 — How to Value Hard Assets and Equipment 03:14 — Buying Into Your Own Accounts Receivable 05:58 — Paying for Organizational Costs and Goodwill 08:17 — Structuring Buy-In Payments (Pre-tax vs. After-tax) 14:32 — Why EBITDA Valuation Fails for Medical Practices 18:52 — The Capital Contribution Model for Medical Groups 21:29 — The Path to Parity Buy-In Model Explained 23:18 — Is Your Partnership Buy-In Set Too High or Low? Neal Goldstein is an experienced healthcare attorney, legal strategist, and board member specializing in medical practice structures. He served as the structural engineer for the founding of the Illinois Bone and Joint Institute and has provided guidance on healthcare governance through his work on hospital system boards. His work focuses on navigating the Stark Law, corporate practice of medicine doctrines, and professional risk management Website: https://www.pfs-law.com/ Website: https://www.goldsteingrouppractice.com/ Website: https://nealtgoldstein.com/ LinkedIn: https://www.linkedin.com/in/neal-t-goldstein-841aa652/ Show subscribe and platform links New episodes every week — subscribe so you never miss a conversation on the business of medicine. Spotify | Apple Podcasts | YouTube Disclaimer This episode is for informational and educational purposes only and does not constitute legal, financial, or medical advice. #MedicalPractice #HealthcareBusiness #PhysicianPartnership #MedicalGroup #PracticeManagement #DoctorLife #MedicalBusiness #HealthcareFinance #PartnershipBuyIn #GroupPractice

    29 min

  4. 16 jun

    Partner Admission:  Admitting an employed physician into partnership

    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 baseline business criteria for partnership. ● Treating staff rudely is a massive red flag that must be corrected sternly before an employed doctor is promoted. ● Medical groups should consider carving out real estate ownership so buy-ins remain affordable for new partners. ● Anti-kickback safe harbors strictly prevent a group practice from financing a new partner’s surgery center buy-in. ● The “income partner” model used by law firms can help medical groups retain talent without giving away voting rights. Timestamps: 00:00 — When is an employed physician eligible for partnership? 03:55 — The business criteria for making an employed doctor a partner 07:00 — Why acceptance by patients and staff is critical for promotion 09:47 — Should new practice partners buy into the medical real estate? 11:58 — Anti-kickback safe harbors and surgery center ownership 15:47 — How the income partner model works for medical groups Neal Goldstein is an experienced healthcare attorney, legal strategist, and board member specializing in medical practice structures. He served as the structural engineer for the founding of the Illinois Bone and Joint Institute and has provided guidance on healthcare governance through his work on hospital system boards. His work focuses on navigating the Stark Law, corporate practice of medicine doctrines, and professional risk management Website: https://www.pfs-law.com/ Website: https://www.goldsteingrouppractice.com/ Website: https://nealtgoldstein.com/ LinkedIn: https://www.linkedin.com/in/neal-t-goldstein-841aa652/ Show subscribe and platform links New episodes every week — subscribe so you never miss a conversation on the business of medicine. Spotify | Apple Podcasts | YouTube Disclaimer This episode is for informational and educational purposes only and does not constitute legal, financial, or medical advice. #MedicalPractice #PhysicianPartnership #HealthcareLaw #PracticeManagement #MedicalGroup #SurgeryCenter #NealGoldstein #GroupPractice #IncomePartner #HealthcareBusiness

    22 min

  5. 9 jun

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

    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 experiences. ● Why plaintiffs typically win “carpentry plumbing” cases, but lose “question of judgment” cases. ● The reason why highly-paid expert witnesses often cancel each other out in the eyes of a jury. ● How a doctor’s inability to admit a harmless mistake can completely destroy their case. ● Why having mutual respect for opposing plaintiff’s counsel is a strategic advantage, not a weakness. Timestamps: 00:00 — Meet Medical Malpractice Defense Lawyer Bill Rogers 03:00 — The First Conversation With a Sued Doctor 04:00 — Why Doctors Win 65-75% of Jury Trials 05:00 — The Emotional Rollercoaster of a Lawsuit 11:00 — The 3 Categories of Malpractice Cases 20:00 — Why Expert Witnesses Cancel Each Other Out 26:00 — Why You Must Respect the Plaintiff’s Bar 30:00 — The Difference Between A Cause and The Cause Guest bio: Bill Rogers is a partner at Swanson, Martin and Bell in Chicago, specializing in defending doctors against medical malpractice claims for decades. He is a fellow of the American College of Trial Lawyers and the recipient of the JVR Trial Lawyer Excellence Lifetime Achievement Award. He has held leadership positions in the American Board of Trial Advocates and the Society of Trial Lawyers. Website: smbtrials.com/brogers LinkedIn: /in/william-j-rogers-664ba625 Show subscribe and platform links New episodes every week — subscribe so you never miss a conversation on the business of medicine. Spotify | Apple Podcasts | YouTube Disclaimer This episode is for informational and educational purposes only and does not constitute legal, financial, or medical advice. #MedicalMalpractice #HealthcareLaw #PhysicianLife #DoctorLawsuit #MedicalDefense #TrialLawyer #GroupPracticePodcast #BillRogers

    37 min

  6. 2 jun

    Professional Risk Management

    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 directly increases clinical quality across medical practices ● The exact columns your litigation tracker needs to isolate dangerous recurring claim trends ● How hospital co-defendants can settle secretly and leave individual physicians vulnerable during malpractice trials ● Why a 2-year gap between the date of loss and filing reveals weak, shopped-around claims ● The operational math check required to catch hidden insurance carrier errors on loss run reports ● How to build an exclusive panel of competitive defense counsel to strengthen your legal positioning ● The critical reason non-physician risk managers require a respected physician champion to implement systemic clinical changes Timestamps: 00:00 — Managing Malpractice Risk as a Business Strategy 01:45 — The Dual Benefits of Quality Improvement and Lower Premiums 03:32 — Designing an Active Litigation Tracker Worksheet 05:12 — Spotting Failure to Diagnose Trends and Coding Issues 09:24 — Tracking Closed Cases, Dismissals, and Settlement Dispositions 11:36 — Managing Precautionary Claims and Suboptimal Outcomes 14:12 — The Full-Time Risk Manager Job Description 17:15 — Auditing Loss Run Reports and Insurance Carrier Reserves 20:44 — How Bad Actor Expert Witness Testimony Damages the Profession 23:22 — Establishing Competitive Panel Counsel for Stronger Defense 25:31 — The Vital Role of a Physician Champion Leader Neal Goldstein is an experienced healthcare attorney, legal strategist, and board member specializing in medical practice structures. He served as the structural engineer for the founding of the Illinois Bone and Joint Institute and has provided guidance on healthcare governance through his work on hospital system boards. His work focuses on navigating the Stark Law, corporate practice of medicine doctrines, and professional risk management. Website: https://www.pfs-law.com/ Website: https://www.goldsteingrouppractice.com/ Website: https://nealtgoldstein.com/ LinkedIn: https://www.linkedin.com/in/neal-t-goldstein-841aa652/ Show subscribe and platform links New episodes every week — subscribe so you never miss a conversation on the business of medicine. Spotify | Apple Podcasts | YouTube Disclaimer This episode is for informational and educational purposes only and does not constitute legal, financial, or medical advice. #MalpracticeDefense #RiskManagement #MedicalPractice #HealthcareOperations #PhysicianLeadership #GroupPractice #InsurancePremiums #HealthcareQuality #MedicalLawyer #LitigationTracker #PhysicianRisk #NeilGoldstein

    28 min

  7. 26 may

    A Medical Group is a Business Arrangement

    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 differences between highly regulated hospital systems and state-licensed physician groups ● How the federal Stark Law explicitly targets the business elements of group practices rather than clinical care ● Why CMS removed centralized utilization review from the unified business definition in the phase two regulations ● How non-physician owners can properly evaluate organizational structures and quality metrics without crossing clinical boundaries ● The unique governance model that allows business executives to support doctors while preserving patient care delivery ● How institutionalizing professional risk management programs directly lowers malpractice claims and secures financial operations 00:00 — Corporate Practice of Medicine and Private Equity Group Ownership Structure 01:18 — Illinois Bone and Joint Institute Founding and Structural Engineering Story 02:51 — Deloitte Technical Review Executive Edward Goldstein Leadership Lessons 03:51 — Small Business Outsourcing CFO Work and Accounting History for Physicians 04:43 — Hospital System Quality Committee Board Governance Versus Physician Group Licensure 05:58 — Stark Law Group Practice Definition and Unified Business Regulation Analysis 06:49 — CMS Phase Two Regulations and Centralized Utilization Review History 08:11 — Separate Clinical Side From Business Side Optimization Strategies 09:07 — Physician Accountability Governance and Non-Physician Executive Roles 10:51 — Professional Risk Management and Medical Malpractice Claims Reduction Neil Goldstein is an experienced healthcare attorney, legal strategist, and board member specializing in medical practice structures. He served as the structural engineer for the founding of the Illinois Bone and Joint Institute and has provided guidance on healthcare governance through his work on hospital system boards. His work focuses on navigating the Stark Law, corporate practice of medicine doctrines, and professional risk management. Website: https://www.pfs-law.com/ Website: https://www.goldsteingrouppractice.com/ Website: https://nealtgoldstein.com/ LinkedIn: https://www.linkedin.com/in/neal-t-goldstein-841aa652/ Show subscribe and platform links New episodes every week — subscribe so you never miss a conversation on the business of medicine. Spotify | Apple Podcasts | YouTube Disclaimer This episode is for informational and educational purposes only and does not constitute legal, financial, or medical advice.

    12 min

  8. 19 may

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

    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 Fee Splitting and CPM are strictly state-level laws with massive enforcement differences across the country ● The critical difference between statutory licensing laws and evolutional common case law in healthcare compliance ● How the historic Berlin v. Sarah Bush Lincoln case accidentally banned hospitals from employing doctors in Illinois ● The exact mechanics of the “Friendly PC / MSO” contract model used to legally bypass corporate ownership bans ● Why structuring a management fee based on a medical practice’s direct profits triggers massive regulatory risks ● The hidden economic reasons why these antiquated 1990s laws remain on the books despite structural changes in GDP ● A collaborative boardroom framework inspired by hospital medical staffs to balance corporate scale with clinical quality Timestamps 00:00 — The Stark Reality of Fee Splitting and Corporate Medicine Statutes 01:22 — Statutory Fee Splitting vs Common Law CPM Compliance 03:06 — Navigating Section 22.2 of the Illinois Medical Practice Act 05:00 — The True Policy and History Behind the Corporate Practice of Medicine 07:26 — The Berlin v. Sarah Bush Lincoln Appellate Decision and Fallout 09:58 — State Enforcement Spectrum: High Risk vs Low Risk Jurisdictions 13:36 — How Private Equity Structures Corporate Healthcare Transactions legally 13:54 — The Friendly PC and MSO Legal Agreement Mechanics 16:36 — Fair Market Value Pitfalls in Management Fee Structuring 18:13 — Why Outdated Healthcare Licensing Laws Still Exist on the Books 22:00 — A Better Boardroom Framework for Medical Group Quality Assurance 25:58 — Wrap Up: Private Equity in Modern Medical Group Ownership Guest Bio: Neal Goldstein is an expert healthcare transaction attorney specializing in regulatory compliance, medical group mergers and acquisitions, and corporate structuring for group practices. Over a multi-decade legal career, he has advised healthcare systems, physicians, and private equity platforms on navigating the complex intersection of corporate scaling and clinical compliance. Website: https://www.pfs-law.com/ Website: https://www.goldsteingrouppractice.com/ Website: https://nealtgoldstein.com/ LinkedIn: https://www.linkedin.com/in/neal-t-goldstein-841aa652/ Show subscribe and platform links New episodes every week — subscribe so you never miss a conversation on the business of medicine. Spotify | Apple Podcasts | YouTube Disclaimer This episode is for informational and educational purposes only and does not constitute legal, financial, or medical advice.

    26 min
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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.

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