What If the Hospital Gets Sold? How That Affects Your Signed Contract

Your signed contract does not magically protect you from a hospital sale. And that’s exactly what makes this so unnerving.

You did the whole thing “right.”
You read the contract (or paid a lawyer). You negotiated a bit. You signed. You started your job. Maybe you moved your family, bought a house, locked kids into schools. And now you hear the four words that make every employed doc’s stomach drop:

“The hospital is being sold.”

Or:
“We’re merging with a large system.”
“A private equity group is buying the practice.”
“We’re affiliating with a new parent company.”

Different words. Same anxiety: Does my contract still mean anything? Can they just wipe it out? Am I about to get screwed?

Let’s go through this like a real human with a low-grade panic running in the background. Because that’s where you’re probably living right now.

---

1. The ugly truth: your contract probably “goes with” the sale

Most physician employment contracts have some version of an “assignment” clause that quietly decides your fate in a sale.

It usually looks like this (or close):

“Employer may assign this Agreement to any successor, affiliate, or entity that acquires substantially all of Employer’s assets, without Physician’s consent.”

Translation: if they sell the hospital/practice, they can hand you over as part of the asset bundle. Your contract just moves under the new owner. You don’t get a veto.

Here’s the part that freaks people out: you usually can’t refuse assignment but still keep your job. It’s all or nothing. If you refuse, you’re probably resigning or being treated as if you did.

In practice, three things usually happen in a sale:

1. Your existing contract is assigned to the new owner “as is” (at least at first).
2. The new owner honors it for some period of time (common: to the end of the current term).
3. Then they try to renegotiate or replace it with their standard template.

The nightmare scenario in your head is: “They buy us and immediately slash salaries, change call, move me across town, and there’s nothing I can do.”

Reality is usually less dramatic but still stressful:

• They may cut future comp models, not current guaranteed amounts.
• They may consolidate services, which could change call/coverage.
• They may push aggressive productivity or RVU targets later.
• They may reduce benefits for new contracts, not necessarily for existing ones (at least not immediately).

Can they legally change your contract the day after closing?
Usually not, unless:

• Your contract is at-will and allows unilateral change (red flag), or
• They give contractual notice of termination and offer a new one under the new system.

But emotionally? You feel like you’re on a ticking clock.

---

2. Assignment clauses: the line in your contract that quietly controls everything

This one clause is where the whole mess lives. If you have your contract handy, find:

• “Assignment”
• “Successors and assigns”
• “Change in control”
• “Merger / acquisition”

It’ll usually say one of three things:

Clause Type	What It Means for You
Employer free assignment	They can transfer your contract in a sale without your consent
No assignment without consent	They need your written approval to assign to a buyer
Silent/unclear	State law and general contract rules fill in the gaps

If you’re already employed and the sale is happening, you’re not rewriting that clause now. But understanding which one you have helps answer the two big questions in your head:

1. Can they just move me to the new owner automatically?

   • If it says they can assign without your consent: yes, they probably can.
   • If it requires your consent: you have leverage, though using it is tricky.

2. If I refuse assignment, am I free from my non-compete?
   Here’s where people get burned.

Some contracts say the non-compete and restrictive covenants survive “any termination for any reason.” Which means even if you refuse assignment, quit, or they terminate you without cause after the sale, your non-compete may still follow you. I’ve watched doctors think, “Great, I’ll just say no and walk.” Then discover they can’t practice within 10–25 miles because the non-compete still bites.

If your contract says restrictive covenants are enforceable by “Employer and its successors and assigns,” then the new owner can try to enforce your non-compete too. Fun, right?

---

3. What actually changes when a hospital is sold (and what doesn’t)

Let’s separate your fear into buckets, because not everything is equally at risk.

Things that usually stay the same — at least initially

• Base salary already guaranteed in a current term
  If you’re in year 2 of a 3-year guarantee, the new owner usually honors what’s on paper until that term ends, unless they terminate you under the contract.

• Non-compete and restrictive covenants
  These almost always survive the sale. A buyer is buying your patient base and referral streams, not just buildings. They care a lot about keeping you from walking across the street.

• Length of your current term
  If your contract says it runs through, say, June 30, 2027, the new owner steps into that obligation — again, unless they trigger a termination clause.

• Any already-earned bonuses or RVU credits
  They might screw up the admin of this (systems change, numbers get “recalculated”), but they can’t just pretend you didn’t earn what’s already accrued under the old system.

Things that are most vulnerable in a sale

• Future renewal terms
  If your deal auto-renews annually, the new owner may simply give notice that they’re not renewing under the old terms, then offer a new, worse contract.

• Comp models tied to “group” or “division” profitability
  A new owner can reorganize service lines, shift expenses, and suddenly your “bonus pool” shrinks even though your work didn’t change.

• Call schedules and work locations
  If your contract is vague (“Location(s) as reasonably determined by Employer”), the new owner can absolutely consolidate clinics, change hospital coverage locations, and “redistribute” call.

• Benefits and CME
  Once they roll you into the new system’s HR structure, expect changes to retirement match, health premiums, CME money, vacation accounting, etc.

• Administrative roles / stipends
  Medical director roles get restructured constantly after a sale. I’ve seen people lose a $40k stipend and a title with one email: “We’re restructuring leadership.”

Common Changes Reported After Hospital/Practice Sale

Category	Value
Comp model	80
Call schedule	65
Benefits	70
Location	50
Non-compete	20

(Values here are rough percentages from what I’ve seen and heard anecdotally — not official survey data. But the pattern is real: comp and call are usually the first casualties.)

---

4. Worst-case scenarios you’re scared of (and how they usually play out)

Let’s name the monsters under the bed.

“They’ll cut my pay in half overnight.”

Could they? They’d usually have to either:

• Give you notice of termination without cause per the contract (e.g., 60–180 days), then offer a new lower-paying deal, or
• Change your comp formula going forward if your contract allows unilateral policy changes.

More common pattern:

Year 1–2: “We’re honoring all current contracts.”
Year 3+: “We’re moving to a standard RVU-based model with system-wide benchmarks.”

Result: Same base, but impossible bonus targets. Or a “market adjusted” base that’s lower than your current one when your term renews.

“They’ll close my site and move me to a location that blows up my life.”

Location changes hinge on the exact language:

• “Primary practice location: [Address]. Physician shall not be required to relocate practice more than X miles without written consent.” → You have decent protection.
• “Practice locations as determined by Employer from time to time.” → They have broad control.

In a sale, buyers love “rationalization of sites” — closing smaller clinics, consolidating into big hubs. I’ve seen docs suddenly told they’re now 45 minutes away, not 8.

Sometimes they offer a modest stipend for travel. Sometimes they shrug. Legally, if your contract gives them that discretion, you’re stuck unless you’re willing to resign and trigger the non-compete analysis.

“They’ll terminate me and still enforce the non-compete.”

This one keeps a lot of people awake.

If your contract allows termination without cause with, say, 90 days’ notice, the buyer can absolutely use it. And unless your non-compete is tied to you resigning (rare) or only to “for cause” terminations (also rare), the non-compete likely still applies.

So yes, worst case: you get a notice letter, you’re out in 90 days, and you’re locked out of your existing market radius.

Is it always enforced that harshly? Not always. I’ve seen:

• Buyers willing to negotiate non-compete releases for a fee.
• Systems who don’t bother enforcing for low-volume, non-lucrative specialties.
• Admins who talk big about enforcement then quietly look the other way.

But I’ve also seen surgeons, cardiologists, GI, and ortho docs dragged into enforcement fights because their referral streams are worth real money.

---

5. What you can actually do if a sale is brewing

You’re probably not going to stop the sale. But you’re not totally powerless.

Step 1: Quietly get your documents and read them like a hawk

You want:

• Your signed employment agreement (all pages, final version).
• Any amendments or addenda.
• Productivity and bonus policies referenced in the contract.
• Any separate non-compete or partnership documents.

Focus on:

• Assignment clause (can they assign without consent?).
• Non-compete (radius, duration, who can enforce).
• Term and termination without cause (notice period).
• Location language.
• Compensation change language (“as per Employer policies,” etc.).

Step 2: Talk to a physician contract attorney (not your hospital’s lawyer)

Not your colleague who “reads a lot of contracts.” Not generic HR. An actual physician-side lawyer who does this weekly.

Pay the consult fee. It’s worth sleeping a little better and actually knowing what’s real vs what’s just in your head.

They can walk you through:

• Under your exact state law, how enforceable is that non-compete?
• If they assign, does anything trigger a right to resign with non-compete relief?
• How much leverage you have if your contract requires consent for assignment.

Step 3: Start quietly planning your “Plan B”

You don’t have to act on it. But you will feel saner if you know:

• What jobs exist within and outside your non-compete radius.
• Which systems/groups are expanding in your specialty.
• Whether locums or telehealth could carry you financially for 6–12 months if the worst happens.

I’ve watched people go from barely holding it together to “Okay, I can breathe” once they identified 2–3 real-world backup options.

Physician Response to Hospital Sale

Step	Description
Step 1	Hear about sale
Step 2	Gather contracts
Step 3	Consult lawyer
Step 4	Build Plan B job list
Step 5	Monitor changes
Step 6	Decide stay or leave
Step 7	High risk?

Step 4: Be very careful about what you say to admin

Your instinct might be to storm into someone’s office and demand answers. That’s cathartic but usually dumb from a leverage standpoint.

Better play:

• Ask calm, factual questions: “Will current contracts be honored through their existing term?” “Will there be changes to locations or call schedules?”
• Document everything. Save emails. Take notes of conversations.
• Don’t threaten, don’t say you’re “definitely leaving,” don’t put anything dramatic in writing.

If things get bad and you end up in a legal fight or at least a negotiation, you don’t want emails where you sounded unhinged.

---

6. How you wish your contract looked before a sale (for next time)

You might be past the negotiation phase now, but file this under “never again” for your next job:

Clauses that would’ve helped you sleep better right now:

• Assignment only with physician consent
  “This Agreement may not be assigned without Physician’s prior written consent, except to a successor that assumes all obligations under this Agreement without modification.”
  That alone forces the buyer to actually negotiate with you.

• Non-compete void if terminated without cause after a change in control
  “If Physician is terminated without cause within 12 months following a change in control, restrictive covenants shall be null and void.”
  That’s gold in a sale.

• Tight location language
  “Primary practice location: [specific address]. Physician shall not be reassigned to a location more than 10 miles from Primary Location without Physician’s written consent.”

• Clear comp protection during initial term
  “Compensation formulas and base salary may not be reduced during the then-current term absent mutual written agreement.”

You probably didn’t have anyone walk you through all that when you signed your first job. Most people don’t. You just wanted a paycheck and a place to land after residency. So now you’re learning the hard way.

That sucks, but it’s also how a lot of people get smarter about contracts.

---

FAQ (exactly 5 questions)

1. If the hospital is sold, does my contract automatically end?
Usually no. Your contract typically gets assigned to the new owner, meaning they step into the employer’s shoes and inherit both your rights and obligations. Your term, non-compete, and compensation structure (as written) normally stay in place initially. The new owner can later choose to terminate you without cause according to the contract’s notice provision and then offer a new contract, but they can’t just erase the existing one on day one unless there’s a specific clause allowing that.

2. Can the new owner force me to sign a new, worse contract?
They can’t force you in the sense of “sign or you’re legally bound anyway,” but they can say, “We’re not renewing your current contract when it expires” or “We’re giving you notice of termination without cause; here’s the new offer.” If you refuse, you may be out of a job and still stuck with a non-compete. That’s the leverage imbalance that makes this feel like coercion. Whether you have any real power to push back depends heavily on your assignment clause, non-compete enforceability in your state, and how replaceable you are in your specialty and market.

3. If I refuse assignment to the new company, am I free of my non-compete?
Not automatically. This is where a lot of people miscalculate. Many contracts say restrictive covenants survive any termination, “for any reason,” and can be enforced by successors and assigns. In that case, refusing assignment can function like a resignation that still triggers the non-compete. In some states and some contracts, you might be able to argue that a material change in employer or duties voids the non-compete, but you shouldn’t assume that. You need a state-specific legal opinion before you act on that hope.

4. Can the buyer cut my pay even if my contract says I have a guaranteed base?
They generally can’t cut the guaranteed base that’s written into your current term without either (a) your agreement or (b) terminating the contract under the existing termination provisions. Where they sneak changes in is through: altering RVU thresholds, changing work RVU credit policies, modifying “group profitability” calculations, or revising call stipends and bonuses that are defined as “subject to Employer policy.” So your guaranteed base might stay intact for now, but your overall take-home could still shift over time via policy changes and a new contract when your term ends.

5. I’m hearing rumors of a sale but nothing official. When should I actually worry?
Start quietly preparing now, but don’t blow anything up yet. That means: gather all your documents, have one consult with a physician contract attorney, and sketch out a backup plan (potential employers, locums options, telehealth). You don’t need to start applying to 40 jobs based on hallway gossip, but you also don’t want to wait until you get a “we’re changing your comp model” email with 60 days’ notice. The mental shift is this: assume change is coming, hope it’s mild, and be ready for it not to be — without panicking yourself into bad decisions.

---

Key points to hold onto:

1. A sale doesn’t vaporize your contract, but it does put a big target on its back for future “standardization.”
2. Your non-compete and assignment clause are the two landmines that decide how trapped or free you are.
3. Quiet preparation — documents, legal review, and a real Plan B — is your best antidote to the “I’m completely at their mercy” feeling.