Three founders were ready to bring in their first partner. One founder researched the price and proposed $2.7 million, which the others accepted. The associate pushed back, and a professional appraisal followed. Corrections to the valuation brought the price to about $500,000. Only the associate had read the appraisal closely. 

Attorneys Robert J. Landau, vice president and shareholder, and Nick R. Masino of Wade, Goldstein, Landau & Abruzzo, P.C., opened "Buy-Ins, Buy-Outs, and Leadership Risk" at the 2026 MGMA Annual Conference with that case. An unreasonable price can stall a deal for months or years, drive the associate out of the group and leave a new partner with less take-home pay than expected. Associates also talk, so a failed buy-in can make the next physician harder to recruit. 

Those mistakes can also complicate succession planning. The share of U.S. physicians in private practice fell to 42.2% in 2024 from 60.1% in 2012, according to the AMA.¹ An MGMA Stat poll in February 2026 found that only 33% of responding medical groups had a succession plan for leadership positions.² Ahead of the conference, Masino and fellow attorney Mark D. Abruzzo told Medical Economics that small independent practices without a successor physician risk being forced to sell. They also said goodwill, including the value of a practice's reputation and patient relationships, is carrying less weight in buy-in and buy-out prices, partly because state noncompete rules are changing.³ 

Landau and Masino organized their session around five questions to resolve before a partner joins, reduces hours or leaves.