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If you've ever signed a physician employment contract, you've probably seen one: a

non-compete clause that limits where you can practice, and for how long, after you leave.

Depending on who you ask, these agreements either protect employers who invest heavily in

recruiting and building a practice, or they unfairly keep physicians from moving within a market

and keep patients from the doctors they already trust. Both sides have a point. And right now,

states are picking sides faster than ever.

The national picture is shifting

A new 50-state guide from law firm Tucker Arensberg lays out just how much has changed.

Eighteen states now generally ban or void physician non-competes, ten states plus Washington,

D.C. allow them only with significant restrictions, five allow them with some restrictions, and

seventeen generally allow them as long as they're reasonable. ramaonhealthcare

What about the federal level? There's no federal ban. The FTC's 2024 rule that would have

barred most non-competes was challenged in court and never took effect, and the agency has

since shifted to targeted enforcement, including in healthcare. ramaonhealthcare

Kansas and Missouri: still wide open

Here's where it gets interesting for those of us in the Midwest. Neither Kansas nor Missouri has

meaningfully restricted physician non-competes.

In Kansas, there's no statute governing non-competes at all, so whether one is reasonable and

enforceable is left to the courts. Those courts weigh whether the agreement protects a

legitimate business interest, whether it unduly burdens the physician, whether it harms the

public, and whether the time and distance limits are reasonable. journeypayrollhrhinklaw

Missouri looks similar. Courts there will uphold a non-compete that is narrowly tailored in time,

geography, and activity and that protects legitimate interests like trade secrets or customer

relationships. Lawmakers have introduced a bill that would ban physician non-competes, but for

now, the old rules still apply. ubglawfisherphillips

Why this matters for rural healthcare Geography plays a big role in how these agreements are judged. A 50-mile restriction might hold up for a specialist in rural Kansas but be considered excessive in Kansas City, where hospitals sit much closer together. pslawkc

For rural hospitals, that cuts both ways. A physician who wants to spend a day or two a week

serving a smaller community may have more flexibility than they think, or they may be closer to

a restriction line than they realize. For physicians, it's worth knowing exactly what your agreement says before you explore part-time or outreach work.

That's a big part of what we do at Midwest Doctor Link. We connect rural hospitals with

physicians and advanced practice providers for long-term, part-time work, so patients can get

specialty care close to home. Many of the providers we work with are established in their

practices and looking to add rural outreach, and understanding the fine print is part of making a

good fit.

This post is for general information only and isn't legal advice. If you have questions about your

own agreement, talk with a healthcare attorney.

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