The physician non-compete: reading the restriction before you sign

How a physician non-compete is built

The non-compete is geometry. A radius, measured in miles, drawn around the practice site, running for a defined period. A wide radius over a long term can mean relocating to keep practicing. A narrow radius over a short one is an inconvenience. The same clause reads very differently depending on those numbers.

A published review of restrictive covenants in employment agreements puts the geographic and time limits at the center of it: that is where reasonableness gets argued. Read the non-solicitation and confidentiality clauses that travel alongside with the same eye.

Three dimensions to evaluate with counsel

Three dimensions are worth putting in front of qualified local healthcare counsel before any discussion with the employer:

• Geography: how large is the radius, and is it measured from one primary site or from every affiliate in the system? A system-wide radius can quietly cover an entire metropolitan area.
• Duration: how long does it run, and how does that compare with what your jurisdiction permits?
• Scope: which activities, if any, are excluded, such as academic positions, hospital employment, government work, locum assignments or telemedicine. Each excluded activity is one the clinician stays free to pursue.

When the employer ends the job

Then the provision counsel will look at hardest: how the covenant operates if the employer terminates without cause, sells the practice or eliminates the position. That is a real issue, and it is worth raising before signature.

Whether it can be addressed, and how, depends on the governing law and the employer. The words that go into the document are counsel's to draft, consistent with that law. This guide names the issue rather than supplying the language.

Is a physician non-compete enforceable?

A review of noncompete enforceability in the medical profession, by the Council of State Neurosurgical Societies, describes it as state-dependent: the same clause can carry very different weight in two different jurisdictions. Some states restrict clinician non-competes outright. The picture has continued to move since that review was published.

One recent chapter many people heard only the beginning of: the 2024 federal rule that would have banned most noncompetes never took effect. It was set aside in court, the Federal Trade Commission dropped its appeals in 2025, and the rule was removed from the regulations in February 2026, so there is no federal ban and the question remains one of state law.

Whether a specific covenant is enforceable where you practice is a question for a licensed local attorney, not a guide. It is the single clearest reason to have one review the document.

Not just a physician issue

In a 2015 national survey of certified registered nurse anesthetists, average noncompete knowledge scored just over half, and nine percent did not know whether their own contract contained one. Every clinical agreement can carry the same restriction, so the same three dimensions apply to a nurse practitioner, PA or CRNA contract.

Agency work has its own version. An agency agreement can restrict working with the same facility directly, or through another agency, for a defined period. Like every restrictive covenant, what that clause is actually worth depends on the law of the state it sits in, and it decides whether an assignment can ever convert into a permanent position. Agency agreements are contracts; review them with counsel the same way.

Why the covenant matters before you need it

A restrictive covenant can put the nearest permitted job outside the market a clinician actually lives in. How far it reaches, and whether it is enforceable at all, depends on the state. That kind of constraint doesn't respond to savings; it responds to having read the agreement before signing it.

Picture the same contract conversation twice. In the first, the clinician needs the position to start on schedule because a gap isn't survivable, so every term the employer proposes is acceptable. In the second, the same clinician can absorb a delay, and now the restrictive covenant gets questioned. Nothing about the clinician's skill or the market changed. What changed is that walking away became an option.

The non-compete at the end of a career

The clause comes back when clinical work winds down. A non-compete may constrain the part-time, locum or consulting work you were planning to do afterward, and the terms vary widely by agreement and by state.

Review the employment agreement before you announce anything, and ask an attorney about any agreement that still binds you after the last shift: restrictive covenants, tail-coverage obligations and deferred compensation terms.

A non-compete review, step by step

Use this with the contract open:

• Find every restriction: non-compete, non-solicitation and confidentiality.
• Measure the non-compete in miles and years, and note where the radius is measured from.
• List which activities are excluded, and which are not.
• Note how the covenant operates if the employer terminates without cause, sells the practice or eliminates the position.
• Write down every question the document didn't answer.
• Take that list to a healthcare attorney licensed where you practice, before signing, and ask for enough review time for your circumstances. Pressure to sign quickly is a flag that outranks the rest.

Where this is taught

This guide draws on Session 7, Employment Agreement Literacy, and Session 8, Negotiation as a Professional Skill, with material from Sessions 4, 17 and 29, all part of the accredited course. Designated by the Postgraduate Institute for Medicine for a maximum of 8 AMA PRA Category 1 Credit(s)™, 8 nursing contact hours, or 8 AAPA Category 1 CME credits.