Almost Clinical

Buttaci Leardi & Werner

Welcome to Almost Clinical, the podcast where healthcare, law, and business converge in the most captivating way. Hosted by the dynamic trio from Buttaci Leardi & Werner – Vincent Buttaci, John Leardi, and Paul Werner – this show is your backstage pass to the gritty, multifaceted world of healthcare management. Every episode brings you face-to-face with the realities of running a healthcare practice, navigating legal hurdles, and capitalizing on business opportunities. Forget the clichés and technical jargon – Almost Clinical is all about accessible, engaging conversations that cut through the noise. Here, you’ll get straight-talking insights and no-nonsense discussions perfect for savvy healthcare leaders and business owners with hectic schedules and a thirst for industry knowledge. What makes Almost Clinical essential listening? It’s all about melding perspectives: ~Clinical Insights: Get the scoop on the latest in medical practice, patient care innovations, and what’s really needed to enhance healthcare delivery. ~Legal Realities: Learn about the pitfalls and legal entanglements healthcare practices face, and why compliance can sometimes feel like navigating a minefield. ~Business Opportunities: Find out who’s making waves in the industry, where the money is flowing, and how to seize emerging opportunities. Almost Clinical isn’t just about talking shop; it’s about understanding the nuances and balancing acts that keep a healthcare practice thriving. Our goal is to make you feel like part of the conversation, providing insights that go beyond headlines and Twitter threads. Our conversations are as engaging and enlightening, featuring guests from all corners of the healthcare world. Whether dissecting a new regulation or exploring innovative business models, we aim to shed light on the issues that impact the day-to-day operations of healthcare practices. So, whether you’re a healthcare leader, a business owner, or simply someone interested in how these fields overlap and influence each other, be sure to tune in to Almost Clinical today!

  1. The Healthcare Lobbyist You Want on Your Side: Laurie Clark Talks Negotiation, Collaboration & Winning the Long Game

    2d ago

    The Healthcare Lobbyist You Want on Your Side: Laurie Clark Talks Negotiation, Collaboration & Winning the Long Game

    There are very few people Vincent Buttaci admits to being afraid of. Healthcare lobbyist Laurie Clark is one of them. In this episode of Almost Clinical, hosts Vincent, John Leardi, and Paul Werner sit down with one of New Jersey's most respected healthcare advocates for a conversation that spans decades of legislative battles, regulatory challenges, pharmacy reform efforts, and hard-earned lessons about influence, negotiation, and playing the long game. A longtime advocate for physicians, pharmacists, healthcare organizations, and professional associations, Laurie offers a rare behind-the-scenes look at how policy actually gets made – and why getting things done often requires far more relationship-building than headline-grabbing victories. Along the way, the group revisits the legislative fight that first put Laurie and Vin on opposite sides of the table, explores the evolution of pharmacy benefit manager reform in New Jersey, discusses the realities of working with regulators and administrative agencies, and explains why some of the most important victories in healthcare happen long before anyone walks into a courtroom. Other highlights include: How Laurie built one of New Jersey's leading independent healthcare lobbying practicesWhy the best advocates focus on solving problems, not just winning argumentsThe legislative battle that transformed Laurie and Vin from adversaries into collaboratorsWhat healthcare providers need to understand about building influence with legislators and regulatorsLessons learned from years of fighting for independent pharmacies and pharmacy benefit manager reformWhy professional associations remain one of the most effective tools for driving changeThe importance of credibility, transparency, and keeping communication lines open, even during difficult negotiationsWhy playing the long game almost always beats chasing a quick winBONUS: Stay until the end to hear Laurie explain why, despite wanting to "kill" Vin during one legislative battle, she ultimately ended up hiring his firm. Produced by Buttaci, Leardi & Werner, this episode is a reminder that influence isn't about being the loudest person in the room. It's about showing up, building trust, and staying at the table long enough to make progress. Join Almost Clinical hosts Vincent Buttaci, John Leardi, and Paul Werner as they challenge each other’s views on how to operate, invest, and succeed in healthcare’s rapidly shifting landscape, translate legalese into business sense for healthcare providers, executives, private equity professionals, and strategic stakeholders, and explore the issues shaping the business of medicine today and tomorrow.

    48 min
  2. Under One Roof: New Jersey’s Integrated Healthcare Revolution

    May 21

    Under One Roof: New Jersey’s Integrated Healthcare Revolution

    New Jersey’s new Integrated Healthcare Facility regulations are here — and they fundamentally change how outpatient healthcare services can be delivered across the state. In this episode of Almost Clinical, hosts Vincent Buttaci, John Leardi, and Paul Werner unpack what may be the most significant behavioral healthcare licensing reform New Jersey has seen in the last 20 years. The guys discuss: The collapse of the old fragmented licensing structureWhat integrated healthcare actually means under the new regulationsThe practical impact on behavioral health operatorsNew staffing, supervision, and compliance obligationsHow the state is reshaping outpatient substance use disorder and mental health treatmentWhy physical therapy, primary care, and behavioral health may finally operate under one coordinated systemThe operational and reimbursement challenges providers should expect nextThe hosts also explore the broader policy implications of the new rules, including harm reduction, relapse management, whole-person treatment, and the increasing expectation that behavioral health providers operate with the same sophistication and compliance infrastructure as traditional healthcare systems. If you own, operate, advise, or invest in healthcare facilities in New Jersey, this episode is essential listening. Powered by Buttaci, Leardi & Werner. Join Almost Clinical hosts Vincent Buttaci, John Leardi, and Paul Werner as they challenge each other’s views on how to operate, invest, and succeed in healthcare’s rapidly shifting landscape, translate legalese into business sense for healthcare providers, executives, private equity professionals, and strategic stakeholders, and explore the issues shaping the business of medicine today and tomorrow.

    57 min

  3. Apr 30

    From Complaint to Catastrophe: How to Keep Patient Allegations From Derailing Your Practice

    Patient complaints are inevitable. Catastrophes aren’t. Hosts Vincent Buttaci, John Leardi, and Paul Werner have seen patient complaints turn into licensing board actions, payer audits, malpractice claims, regulatory investigations, and even criminal exposure. And many of these started with a simple question about a bill, a scheduling issue, or a misunderstanding that was handled poorly by a provider.  In this episode of Almost Clinical, the guys walk through the real-world risks behind patient complaints and the practical steps healthcare providers can take to manage them before they spiral.  Highlights include:  Why ignoring a complaint is never an optionThe critical mistakes that immediately escalate risk How empathy isn’t just good customer service, it’s risk management The importance of having a clear internal chain of commandWhen a situation can be handled internally – and when it can’tHow AI and “informed” patients are changing the nature of complaintsReal examples of small issues turning into major legal problemsThe takeaway is simple: you can’t control what patients say, but you can control how you respond. And that response will determine what happens next for you and your business. Join Almost Clinical hosts Vincent Buttaci, John Leardi, and Paul Werner as they challenge each other’s views on how to operate, invest, and succeed in healthcare’s rapidly shifting landscape, translate legalese into business sense for healthcare providers, executives, private equity professionals, and strategic stakeholders, and explore the issues shaping the business of medicine today and tomorrow.

    44 min

  4. Mar 31

    What’s Up, Doc? The Truth About Physician Non-Competes

    Physician non-competes aren’t about fairness. They’re about leverage. In this episode of Almost Clinical, hosts Vincent Buttaci, John Leardi, and Paul Werner break down the reality behind physician restrictive covenants – what they’re supposed to do, what they actually do, and why they’ve gotten so aggressive. What used to be simple – one year, ten miles – has turned into multi-location, multi-state restrictions that many doctors can’t realistically challenge, even when they should. So, the real question isn’t just whether these agreements are enforceable. It’s who can afford to fight them, and who can’t. The guys explore: What restrictive covenants actually include and what really matters;Why non-competes in healthcare are expanding and who benefits;The “rule of reason” test and why it’s anything but predictable;How private equity has changed the landscape;The real-world problem: most physicians can’t afford to challenge bad contracts;The overlooked stakeholder: patients and their ability to follow their doctor;Why non-solicitation clauses may matter more than non-competes; andLegislative efforts to rein things in and why clarity is still unlikely.And perhaps most importantly: Why the smartest move often isn’t litigation – it’s negotiation. Because in a system this fact-specific and this expensive, “winning” in court is rarely the clean outcome anyone thinks it is. Bottom line: Non-competes in healthcare aren’t just legal issues – they’re business decisions. And increasingly, they’re messy ones. Join Almost Clinical hosts Vincent Buttaci, John Leardi, and Paul Werner as they challenge each other’s views on how to operate, invest, and succeed in healthcare’s rapidly shifting landscape, translate legalese into business sense for healthcare providers, executives, private equity professionals, and strategic stakeholders, and explore the issues shaping the business of medicine today and tomorrow.

    44 min

  5. Feb 24

    Man in the Middle: Embracing ADHD & Neurodiversity in the Workplace

    What happens when a neurotypical partner finds himself navigating two diagnosed ADHD partners? What does it look like when successful professionals discover later in life that the “quirks” they’ve worked around for decades have names, diagnoses, and treatment options? And if you’re a young professional - in law, healthcare, or any demanding field - trying to learn your craft while navigating strong personalities and competing management styles, how do you know you’re not failing… but simply wired differently? In this episode of Almost Clinical, powered by Buttaci, Leardi, & Werner, hosts Vincent Buttaci, John Leardi, and Paul Werner pull back the curtain on something the professional world – including law firms, healthcare facilities, and medical practices – didn’t meaningfully discuss until recently: neurodiversity in the workplace. What begins as an honest look at one firm’s internal dynamic becomes a broader conversation about leadership, performance, and self-awareness in high-pressure industries.  Vincent and John share their late-in-life ADHD diagnoses and how that awareness reshaped the way they practice law, advise healthcare clients, and lead teams.  Paul offers the equally important perspective of building structure, process, and adaptability inside a partnership where different minds operate differently – and how that balance contributes to a strong, effective firm. The episode explores: What ADHD actually looks like in high-performing professionals, including attorneys, physicians, and healthcare executivesMedication, stigma, and the power of self-awarenessPractical workplace adjustments that help professionals perform at their best - not out of legal obligation, but as a matter of effective leadership Why neurodiversity isn’t about lowering standards, it’s about unlocking potentialHow law firms and healthcare facilities alike can build environments where different minds thriveAt its core, this episode isn’t about labels.  It’s about understanding how people work, especially in high-pressure industries where patient care, compliance, litigation, and operational risk are all on the line. Join Almost Clinical hosts Vincent Buttaci, John Leardi, and Paul Werner as they challenge each other’s views on how to operate, invest, and succeed in healthcare’s rapidly shifting landscape, translate legalese into business sense for healthcare providers, executives, private equity professionals, and strategic stakeholders, and explore the issues shaping the business of medicine today and tomorrow.

    52 min

  6. Jan 30

    The Most Dangerous Letter a Licensed Professional Can Receive: A Guide to Not Making It Worse

    Most licensing board letters are written to sound harmless when they are, in fact, anything but. In this episode of Almost Clinical, powered by Buttaci, Leardi, & Werner, hosts Vincent Buttaci, John Leardi, and Paul Werner break down what really happens when a professional licensing board comes knocking – and why even the most “innocuous” inquiry can spiral into something far more serious. Drawing on decades of experience defending licensed professionals across New York and New Jersey, the conversation covers: Why licensing board inquiries are never just “requests for information”How minor complaints can quickly expand into full-scale investigationsThe real, long-term consequences of board discipline (including public records and Data Bank reporting)Why trying to “explain it yourself” often makes things worsThe hidden risks in billing disputes, patient complaints, and mandatory reportingHow early decisions — especially written responses — can shape the entire outcomeAlong the way, the hosts share real-world war stories, practical guidance, and a few hard truths about how licensing boards actually operate behind the scenes. If your livelihood depends on a professional license – or you employ people whose livelihoods do – this is a conversation worth hearing before you ever receive that letter. Join Almost Clinical hosts Vincent Buttaci, John Leardi, and Paul Werner as they challenge each other’s views on how to operate, invest, and succeed in healthcare’s rapidly shifting landscape, translate legalese into business sense for healthcare providers, executives, private equity professionals, and strategic stakeholders, and explore the issues shaping the business of medicine today and tomorrow.

    51 min

  7. 12/17/2025

    Three Partners. Two Decades. One Firm: Then, Now & What’s Next

    Every firm has an origin story. This one starts in a bathroom, involves a risky career move away from a stable Big Law job, and turns into a 20-year healthcare law firm that still works. In this episode of Almost Clinical, healthcare attorneys Vincent Buttaci, John Leardi, and Paul Werner reflect on the founding and evolution of Buttaci, Leardi & Werner, a healthcare law firm built without a roadmap – and kept together by trust, judgment, and a willingness to figure things out in real time. The conversation begins with the “then”: shared office space, dictated letters, loud fax machines, and taking the healthcare legal work that paid the bills. The hosts explain what practicing healthcare law looked like in the mid-2000s and how learning on the fly shaped the firm’s approach to clients, risk, and problem-solving. From there, the discussion moves to the “now.” Buttaci, Leardi & Werner operates as a nationally respected healthcare boutique representing physicians, healthcare organizations, and healthcare investors in regulatory, transactional, and litigation matters. The hosts break down how technology, consolidation, and increasingly sophisticated clients have changed the role of healthcare attorneys from ‘document donkeys’ to true business advisors..  The episode closes with a look ahead. Vincent, John, and Paul discuss where healthcare law and healthcare business are headed next, how artificial intelligence and automation are reshaping legal practice, and why independence, trust, and partnership still matter in a rapidly consolidating healthcare industry. In this episode, we discuss: How Buttaci, Leardi & Werner was founded and why the early years matteredWhat practicing healthcare law looked like 20 years ago versus todayHow trust and disagreement support long-term law firm partnershipsThe shift from survival-mode legal work to intentional practice growthHow technology changed healthcare law, firm operations, and client expectationsWhy mentorship in law still requires learning the hard wayWhat’s next for healthcare providers, healthcare investors, and healthcare attorneysProduced by Buttaci, Leardi & Werner, this episode is less about nostalgia and more about longevity – what holds up over time, what falls apart, and what’s worth carrying forward in healthcare law and business. Join Almost Clinical hosts Vincent Buttaci, John Leardi, and Paul Werner as they challenge each other’s views on how to operate, invest, and succeed in healthcare’s rapidly shifting landscape, translate legalese into business sense for healthcare providers, executives, private equity professionals, and strategic stakeholders, and explore the issues shaping the business of medicine today and tomorrow.

    54 min

  8. 10/22/2025

    EKRA: The Law That Changed How Behavioral Health Does Business

    In the latest episode of Almost Clinical, hosts and healthcare attorneys Vincent Buttaci, John Leardi, and Paul Werner dissect the Eliminating Kickbacks in Recovery Act (EKRA) and what the recent Ninth Circuit decision means for behavioral health providers, labs, and investors. EKRA isn’t just another compliance acronym – it’s the law that upended how behavioral health operators, treatment facilities, and clinical labs market and grow their businesses. What began as Congress’s response to rampant patient-brokering and kickback schemes has evolved into one of the broadest and most unforgiving enforcement tools in healthcare. Vincent, John, and Paul explain how EKRA expanded beyond the Anti-Kickback Statute, why “creative” inducements can now carry criminal risk, and how the Ninth Circuit’s decision made it clear that third-party marketers and investors are not immune. They also dig into real-world scenarios – from “free” flights and charitable donations to commission-based pay – that illustrate just how easy it is to step over the line. Listeners will learn: How EKRA closed the loopholes left by the Anti-Kickback Statute;Why behavioral health became ground zero for kickback enforcement;What the Ninth Circuit’s ruling changes for marketers and investors;Why “intent” won’t protect you when enforcement comes calling;How free housing, charitable donations, and profit sharing can cross the line;What whistleblowers and DOJ pilot programs mean for operators;Practical strategies for staying compliant without killing your business, and so much more.Please note that this episode discusses various forms of addiction and substance abuse facilities/programs. If you or someone you know is struggling with addiction, don’t be afraid to ask for help. Please contact ReachNJ at 844.732.2465 or reachnj.gov. Someone will be there to listen. Produced by Buttaci, Leardi & Werner, the healthcare law boutique helping providers and investors navigate what’s legal, what’s risky, and what’s next. Join Almost Clinical hosts Vincent Buttaci, John Leardi, and Paul Werner as they challenge each other’s views on how to operate, invest, and succeed in healthcare’s rapidly shifting landscape, translate legalese into business sense for healthcare providers, executives, private equity professionals, and strategic stakeholders, and explore the issues shaping the business of medicine today and tomorrow.

    46 min
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4.7
out of 5
13 Ratings

About

Welcome to Almost Clinical, the podcast where healthcare, law, and business converge in the most captivating way. Hosted by the dynamic trio from Buttaci Leardi & Werner – Vincent Buttaci, John Leardi, and Paul Werner – this show is your backstage pass to the gritty, multifaceted world of healthcare management. Every episode brings you face-to-face with the realities of running a healthcare practice, navigating legal hurdles, and capitalizing on business opportunities. Forget the clichés and technical jargon – Almost Clinical is all about accessible, engaging conversations that cut through the noise. Here, you’ll get straight-talking insights and no-nonsense discussions perfect for savvy healthcare leaders and business owners with hectic schedules and a thirst for industry knowledge. What makes Almost Clinical essential listening? It’s all about melding perspectives: ~Clinical Insights: Get the scoop on the latest in medical practice, patient care innovations, and what’s really needed to enhance healthcare delivery. ~Legal Realities: Learn about the pitfalls and legal entanglements healthcare practices face, and why compliance can sometimes feel like navigating a minefield. ~Business Opportunities: Find out who’s making waves in the industry, where the money is flowing, and how to seize emerging opportunities. Almost Clinical isn’t just about talking shop; it’s about understanding the nuances and balancing acts that keep a healthcare practice thriving. Our goal is to make you feel like part of the conversation, providing insights that go beyond headlines and Twitter threads. Our conversations are as engaging and enlightening, featuring guests from all corners of the healthcare world. Whether dissecting a new regulation or exploring innovative business models, we aim to shed light on the issues that impact the day-to-day operations of healthcare practices. So, whether you’re a healthcare leader, a business owner, or simply someone interested in how these fields overlap and influence each other, be sure to tune in to Almost Clinical today!

Information

  • Creator
    Buttaci Leardi & Werner
  • Years Active
    2025 - 2026
  • Episodes
    13
  • Rating
    Explicit
  • Copyright
    © 2026 Almost Clinical
  • Show Website
    Almost Clinical