Group Practice with Neal Goldstein

Neal Goldstein
  • 5.0 (3)
  • Medicine
  • Updated Weekly

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. 2d ago

    The Art of the Physician Buyout

    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 paid over two to three years. ● Accounts receivable collections should be paid out for no more than 12 to 24 months. ● Partners who leave without sufficient notice can be penalized with an overhead charge on their collections. ● Doctors leaving for warmer climates before retirement may forfeit their full buyout amount. ● Breaching a non-compete agreement can result in the complete loss of a buyout payment. ● Private equity transactions do not set the standard market rate for standard medical partner redemptions. Timestamps: 00:00: Structuring medical buyout parity. 01:57: Calculating hard asset and AR values. 05:57: Penalties for insufficient departure notice. 10:30: Practicing out of state after retiring. 13:39: Handling practice leases and loans. 18:55: Breaching your medical non-compete. 19:40: Private equity vs standard buyouts. 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. #Healthcare #Business #MedicalPractice #PhysicianBuyout #PrivateEquity #HealthcareLaw #GroupPractice #PartnerRedemption #NealGoldstein

  2. Aug 11

    A Pod on Redemption

    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 rare in physician groups but common in law firms. ● How mandatory age-based buyouts fuel healthy succession planning and organizational growth. ● The specific strategy to avoid age discrimination lawsuits when requiring older partners to step down. ● Why you should never guarantee ongoing employment upfront to a partner who was just bought out. ● How early profit-sharing plans prevent the tragedy of a doctor who cannot afford to retire. ● The exact structural provisions needed to handle a partner who flatly refuses to sell their shares. Timestamps: 00:00 – Introduction to medical partner buyouts 02:13 – Understanding mandatory redemptions 04:54 – Reaching redemption age and succession planning 07:50 – Avoiding age discrimination claims 09:28 – Employing a physician after their buyout 11:34 – Handling partners who cannot afford retirement 15:00 – Dealing with partners who refuse to redeem 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. #GroupPractice #HealthcareLaw #PartnerBuyout #MedicalPractice #SuccessionPlanning #PhysicianRetirement #BusinessOfMedicine #HealthcareBusiness #PracticeManagement #MedicalGroup #PartnershipAgreement

  3. Aug 4

    The False Comfort of Federal Carveouts

    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. ● How the Anti-Kickback Statute, Stark Law, and False Claims Act apply to modern healthcare contracts. ● Why the Office of Inspector General views these private arrangements as disguised remuneration for federal business. ● How treating just one federal patient can trigger massive legal consequences for your entire arrangement. ● The exact reason state statutes like the Insurance Claims Fraud Prevention Act can destroy private pay setups. ● Lessons from the 2007 Chicago MRI scandal where 20 centers were caught executing sham per-click leases. ● Why you must never trust a medical salesperson’s legal assurances over your own healthcare attorney. Timestamps: 00:00 – Defining federal carve-outs in healthcare contracts 00:44 – The three main federal fraud and abuse laws explained 03:47 – The Office of Inspector General’s view on disguised kickbacks 07:01 – Hidden risks of secondary payers and commercial insurance 09:58 – State-level enforcement and the Illinois MRI kickback scandal 16:40 – Why trusting industry salespeople is a major liability 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. #HealthcareLaw #MedicalPractice #AntiKickbackStatute #StarkLaw #HealthcareFraud #MedicalCompliance #HealthcareAdministration #HealthLaw #GroupPracticePodcast #FederalCarveOuts

  4. Jul 28

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

    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 strategic move. What you will learn: ● Why relying only on your lawyer and accountant leaves money on the table during a practice sale. ● The three non-financial pillars of a successful private equity partnership: control, resources, and track record. ● How multiple bidders in a competitive process force buyers to offer better terms and higher valuations. ● Why younger doctors might benefit from selling now to avoid pouring millions into practice growth. ● The reality of the second bite and why future sales are shifting toward payers and distributors instead of larger funds. ● Why accepting your medical practice as a business arrangement is crucial to maintaining your independence. Timestamps: 00:00 : Why Physicians Need an Investment Banker 03:01 : Evaluating Private Equity Cultural Fit and Control 06:09 : Creating Competitive Leverage to Maximize Valuation 10:00 : Navigating Healthcare Mergers and PGP’s Track Record 14:02 : Dispelling the Biggest Private Equity Myths in Medicine 20:12 : Why Younger Doctors Are Choosing to Sell Their Practices 30:52 : The Future of the Second Bite and Medical Acquisitions 35:29 : Treating Your Medical Group Like a Business Arrangement Michael Kroin is the co-founder of Physician Growth Partners (PGP), a premier healthcare investment banking firm based in Chicago. Drawing from his family’s deep roots in medicine, Michael is a fierce advocate for independent physicians. He has successfully guided over 90 transactions, ensuring doctors find the right cultural and financial partners. Website: physiciangrowthpartners.com LinkedIn: https://www.linkedin.com/company/physician-growth-partners-llc/ New episodes every Tuesday, subscribe so you never miss one. Spotify | Apple Podcasts | YouTube Disclaimer This episode is for informational and educational purposes only and does not constitute legal, financial, or medical advice. #Business #Investing #MedicalPractice #PrivateEquity #HealthcareBusiness #PhysicianFinance #PracticeManagement #InvestmentBanking #MichaelKroin #GroupPracticePodcast

  5. Jul 21

    Contractual Indemnities

    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 explicitly excludes contractual indemnification claims. ● How hospital agreements force independent doctors to pay for corporate legal defense and early settlement costs. ● The exact contract wording you must watch out for in your next professional services agreement. ● Why large hospitals try to push negligent credentialing liability onto the shoulders of independent physicians. ● Actionable strategies to push back on in-house counsel and successfully negotiate out toxic clauses. ● How rejecting these unfair contractual provisions directly strengthens the future of independent private practice. Timestamps: 00:00 – The danger of hospital indemnity clauses 00:43 – Breaking down standard physician contract language 04:02 – Why malpractice insurance denies indemnity coverage 06:33 – The infinite financial exposure of private doctors 11:00 – Hospital negligent credentialing tactics explained 15:02 – How to properly negotiate your professional services agreement 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. #Healthcare #MedicalBusiness #PhysicianContracts #MedicalMalpractice #PrivatePractice #HealthcareLaw #RiskManagement #MedicalGroup #ContractualIndemnity #PSAAgreements

  6. Jul 14

    ASC Strategies For The Group Practice

    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 surgical group. ● How owning the surgery center directly meets the intent of the ASC safe harbor under the Anti-Kickback Statute. ● The hidden operational and financial cost of bringing outside specialties into your ASC to hedge risk. ● Why group practice owners must agree not to invest in competing surgery centers to ensure long-term success. ● How to successfully navigate Certificate of Need (CON) applications without needing a hospital partner. ● The financial advantage of buying and retrofitting an aging ASC instead of building a new facility from scratch. ● Why building a surgery center is highly profitable and competitive even if you operate in a non-CON state. Timestamps: 00:00 — Why controlling the site of service saves independent medicine 04:00 — Structuring ASC ownership inside the group practice 09:28 — Why single-specialty ASCs are more profitable 13:59 — Non-competes and loyalty among group practice owners 17:21 — How to obtain a CON without a hospital partner 24:58 — Buying an existing ASC vs. building a new facility 28:36 — ASC valuation and strategy in non-CON states 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 #ASCStrategy #HealthcareBusiness #SurgeryCenter #IndependentMedicine #MedicalGroup #PracticeManagement #NealGoldstein #CertificateOfNeed #HealthcareInvestment

  7. Jul 7

    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

  8. Jun 30

    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

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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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