The decision to leave hospital employment for independent practice is not just a financial calculation; for many physicians, it is a geographic one.
Ahmed Hasan, MD, president of Lehigh (Pa.) Gastroenterology Associates, knows physicians who recently went independent and are commuting 50 miles each way to practice, driving 100 miles a day rather than violate a noncompete clause in a contract they signed years ago.
“These are the real downsides of the employed model,” Dr. Hasan told Becker’s.
According to Dr. Hasan, hospital networks in the Lehigh Valley and elsewhere hold 20 or more facilities across a region and write noncompete clauses covering a 20-mile radius of each one. In markets where a single health system has that kind of footprint, a physician who wants to go independent may find there is nowhere within a reasonable distance to practice. When one Pennsylvania gastroenterologist’s contract wasn’t renewed, he was barred from working within 10 miles of hospitals owned by his former employer and its main rival, more than 50 hospitals between the two systems. He ultimately relocated to West Virginia.
The scope of the problem is national. The American Medical Association estimates that between 37% and 45% of physicians have a noncompete clause in their employment contract, making it one of the most pervasive restrictions in medicine. Eight states passed new restrictions in 2025 alone — Arkansas, Colorado, Illinois, Indiana, Montana, Oregon, Texas and Utah — an acceleration driven in part by the collapse of the FTC’s nationwide ban, which a federal court in Texas blocked in August 2024 and the FTC formally abandoned in September 2025.
“Noncompetes take away the ability to use geography as a tool to control the workforce,” Marcelo Hochman, MD, a Charleston-based independent physician and former president of the Independent Doctors of South Carolina, told Becker’s. “They were designed for high-level executives with access to intellectual property. Now they’re being applied to everyone.”
R. Michael Meneghini, MD, spent several years driving three hours a day to work outside the geographic limits of a noncompete agreement. He told Becker’s that he believes the practice should be illegal.
“It interferes with the doctor-patient relationship,” he said. “Patients should be able to continue seeing the physician they trust.”
Unlike traditional corporate industries, he argues, medicine depends on continuity, trust and long-standing relationships that cannot simply be transferred to another provider because an employment agreement requires it.
The legislative response has been accelerating. Minnesota enacted one of the country’s most expansive noncompete bans for physicians, and the state attorney general opened an investigation into Aspirus Health after physicians alleged post-merger contract revisions retained restrictive covenants in violation of that law. Arkansas and Wyoming enacted full bans. Pennsylvania capped enforceability at one year and only if the physician voluntarily leaves. Texas limits physician noncompetes to one year and a five-mile radius and caps buyout clauses at no more than a physician’s annual salary. Indiana went further still, banning noncompetes between physicians and hospitals outright as of July 1, 2025.
In markets where a single system dominates and noncompete geography is broad, the effective barrier to independent practice is physical. A physician who cannot practice within 20 miles of 20 hospital facilities in a densely populated region has, in practical terms, been removed from the market.
“Hospitals have everyone sign the same blanket noncompete,” Dr. Hochman told Becker’s. “And notably, hospitals never bring up the issue of patients being unable to follow their physician — we raise that; they never do.”
The patient side gets less attention than the physician side, but it may carry the higher stakes. When a physician is forced out of a market by a noncompete, patients who had a relationship with that physician lose continuity of care. They are often redirected to a network specialist they have never met, often with no explanation of why.
“It abridges the patient’s rights to follow their doctor,” Dr. Hochman said. “Senior patients, or patients where 30 to 45 minutes just may not be feasible — that option disappears.
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