Federal ban fades, state rules decide.
Noncompete clauses have long shaped physician employment contracts by restricting opportunities once a position ends. For orthopaedic surgeons, these agreements can interfere with patient continuity and create career disruptions through relocation requirements or costly buyouts. The FTC’s nationwide noncompete ban never took effect, and the agency recently voted to vacate the rule, leaving enforcement to state law and case-by-case actions. With states tightening terms and courts weighing in, the precise contract language you sign now carries greater weight for future practice options.
Map your recruiting targets before you sign.
Today’s constraints are state-specific and uneven. A current policy tracker notes that noncompetes are governed at the state level, that four states ban them entirely, and that many more restrict their use in defined ways. If you plan to change employers across state lines, review statutory limits up front rather than after receiving a draft.
Healthcare carve-outs are getting tighter.
A recent legal update focused on health care reports a clear trend toward narrower, more prescriptive physician clauses. Many states now confine duration to about one year and define geographic scope by fixed miles or political boundaries, with examples that include Louisiana’s parish-based limits, Maryland’s ten-mile cap, Connecticut’s fifteen-mile cap, West Virginia’s thirty-mile cap, and Tennessee’s allowance of up to two years. These laws also increasingly tie enforceability to how the relationship ends, such as voiding a restriction after termination without cause or when no bona fide renewal is offered.
Texas is a preview of the details that matter.
Texas enacted SB 1318 with effective date September 1, 2025, tightening physician noncompetes to one year in duration and a five-mile radius from the primary practice location. Buyouts cannot exceed the physician’s total annual salary and wages at termination, and a noncompete is void if you are terminated without good cause. The statute also extends similar restrictions to dentists, nurses, and PAs. If your agreement involves multiple clinics, clearly defining the “primary” site reduces later disputes.
What this means when you negotiate.
Expect counsel to anchor duration near one year and to hard-code narrower distance terms, especially in hospital-employed roles. That pattern is reflected across several state statutes cataloged in recent health care legal analysis. When recruiting, confirm whether a candidate’s current state treats health-care-specific clauses differently than general worker clauses, then align signing timelines to any new-law effective dates shown on state trackers.
A quick scenario to sanity-check your clause.
Hypothetical: You leave a hospital-employed shoulder and elbow position in Austin and the agreement restricts you for one year within five miles of your primary clinic, with a buyout pegged to your last year’s salary. Under SB 1318 those terms reflect the new Texas framework, and the restriction would be void if the hospital ended your contract without good cause.
Bottom line.
With the FTC ban off the table, your mobility and your group’s recruiting strategy depend on state law and specialty-specific rules. Use current legal summaries to set realistic guardrails before the offer stage, and document the “primary practice location” with precision in any agreement.
Disclaimer: This article is intended for informational purposes only and should not be taken as legal advice. Physicians considering employment contracts should consult qualified legal counsel familiar with state and federal law.
