Physician Non-Competes by State: What's Enforceable in 2026 and How to Negotiate the Clause

If you are reviewing an employment offer, the restrictive covenants may matter more to your career than the base salary. A non-compete can dictate where you are allowed to work for a year or two after you leave — and for a physician with an established patient panel and referral relationships, that is a very big deal. The good news is that the legal ground has been shifting in physicians' favor. The complicated news is that enforceability still depends heavily on the state you practice in, and on the exact wording of your contract.

This is general education, not legal advice. Restrictive-covenant law is state-specific, fact-specific, and changing quickly. Always have a health-law attorney licensed in your state review your actual agreement before you sign.

Two clauses, two different problems

Contracts usually bundle several "restrictive covenants." The two that affect you most are:

• Non-compete. Restricts you from practicing medicine within a defined geographic area for a defined period after you leave. This is the one that can force you to move or commute.
• Non-solicit. Restricts you from actively recruiting the employer's patients, referral sources, or staff after you leave. Courts often treat non-solicits as more reasonable and easier to enforce than outright non-competes.

Watch for overlap. A broadly written non-solicit can function like a back-door non-compete if it effectively bars you from treating anyone connected to your former group. Read both clauses together, not in isolation.

The big picture: the ground is shifting

Between 2023 and 2025, the direction of travel was unmistakable — toward restricting or banning non-competes, with physicians frequently singled out for extra protection.

The FTC rule that almost was

In 2024 the Federal Trade Commission issued a rule that would have banned most non-competes nationwide. It never took effect: a federal court set the rule aside, blocking it from being enforced across the country. So there is no federal ban today. What the episode signaled, though, was a strong policy current against non-competes — one that state legislatures have continued to act on independently.

States are moving to restrict them

A handful of states void non-competes for essentially all workers, which sweeps in physicians:

• California, North Dakota, and Oklahoma have long treated non-competes as generally unenforceable.
• Minnesota banned non-competes for new agreements entered into on or after its 2023 effective date.

Beyond the blanket-ban states, a growing number have adopted physician-specific rules — limiting duration and geographic reach, voiding the clause when the physician is terminated without cause, or requiring patient notice. Colorado has tightened its non-compete law and added protections aimed at health-care providers. Connecticut and Massachusetts are among the states that specifically limit or bar physician non-competes. Indiana enacted restrictions on physician non-competes in recent years, including moves against them for certain primary-care physicians.

Some states take a different tack: they permit physician non-competes but attach strings. Texas, for example, allows them only if the agreement gives the physician a buyout at a reasonable price and preserves access to patient records and lists so continuity of care isn't disrupted.

The takeaway: do not assume your clause is enforceable, and do not assume it is void. You have to check your specific state, and check it as of the date you're signing, because these statutes keep changing.

How enforceability actually works

Outside the blanket-ban states, most courts ask whether a non-compete is reasonable — and reasonableness turns on a few recurring factors:

• Legitimate business interest. The employer generally has to be protecting something real (patient relationships, referral goodwill, investment in building a practice) — not just insulating itself from ordinary competition.
• Scope in time and geography. The narrower the radius and the shorter the duration, the more likely a court upholds it.
• Public interest / access to care. Courts increasingly weigh patient access, especially for specialists in underserved areas where you may be one of few providers.
• How the relationship ended. Some states won't enforce a non-compete against a physician terminated without cause.

Also learn how your state handles an overbroad clause. Some states will "blue-pencil" — narrow an unreasonable clause to something enforceable. Others throw out an overbroad covenant entirely. That single difference changes your whole negotiating posture.

Typical scope — and why the numbers vary

Non-competes are usually written as a mileage radius around your practice site(s) plus a time period, commonly on the order of one to two years. Ranges vary widely by specialty, market, and state, so treat any specific figure in your draft as a starting point for negotiation, not a fixed standard. A tight radius around a single clinic is very different from a broad radius measured from every location a large system operates.

Carve-outs worth negotiating

You rarely have to accept the clause as drafted. High-value asks:

• Tie it to your primary site. Limit the radius to the location(s) where you actually practiced, not every facility the employer owns across the region.
• Void it if you're terminated without cause. If the employer ends the relationship (or doesn't renew), the restriction should fall away. Same logic if the employer breaches — for example, by failing to pay you.
• Add a buyout. Negotiate a defined dollar amount that releases you from the non-compete. A predictable buyout is far better than an open-ended fight.
• Shrink time and distance. Push for a shorter term and a smaller radius. Even modest reductions can be the difference between staying in your community and relocating.
• Protect continuity of care. Preserve your right to keep treating patients who seek you out on their own, and to access records needed for their care. Distinguish patients who follow you voluntarily from those you actively solicit.
• Carve out call, moonlighting, locums, and academic work if those aren't the competitive activity the employer actually cares about.
• Fix the geography's anchor point. Specify that the radius is measured from your assigned site, and pin the address, so a later reassignment can't quietly expand your restricted zone.

Always get a health-law attorney

Two physicians with nearly identical contract language can get opposite outcomes in two different states. An experienced health-law attorney in your state will know whether your clause is even enforceable, whether your state blue-pencils, whether physician-specific statutes apply, and which carve-outs are realistically winnable. The American Medical Association has adopted policy critical of non-competes that restrict physician practice, and its resources can help you understand the landscape — but they are no substitute for a lawyer reviewing your actual document. The cost of a contract review is trivial next to the cost of being forced out of your market for two years.

Negotiate the covenants with the same seriousness you bring to compensation. In the long run, your freedom to practice where you live may be worth far more than a bump in base pay.

References

• Federal Trade Commission — federal non-compete rulemaking and its status
• American Medical Association — physician non-compete policy and contract resources