Every firm has an origin story. This one starts in a bathroom, involves a risky career move away from a stable Big Law job, and turns into a 20-year healthcare law firm that still works.

In this episode of Almost Clinical, healthcare attorneys Vincent Buttaci, John Leardi, and Paul Werner reflect on the founding and evolution of Buttaci, Leardi & Werner, a healthcare law firm built without a roadmap – and kept together by trust, judgment, and a willingness to figure things out in real time.

The conversation begins with the “then”: shared office space, dictated letters, loud fax machines, and taking the healthcare legal work that paid the bills. The hosts explain what practicing healthcare law looked like in the mid-2000s and how learning on the fly shaped the firm’s approach to clients, risk, and problem-solving.

From there, the discussion moves to the “now.” Buttaci, Leardi & Werner operates as a nationally respected healthcare boutique representing physicians, healthcare organizations, and healthcare investors in regulatory, transactional, and litigation matters. The hosts break down how technology, consolidation, and increasingly sophisticated clients have changed the role of healthcare attorneys from ‘document donkeys’ to true business advisors..

The episode closes with a look ahead. Vincent, John, and Paul discuss where healthcare law and healthcare business are headed next, how artificial intelligence and automation are reshaping legal practice, and why independence, trust, and partnership still matter in a rapidly consolidating healthcare industry.

In this episode, we discuss:

• How Buttaci, Leardi & Werner was founded and why the early years mattered
• What practicing healthcare law looked like 20 years ago versus today
• How trust and disagreement support long-term law firm partnerships
• The shift from survival-mode legal work to intentional practice growth
• How technology changed healthcare law, firm operations, and client expectations
• Why mentorship in law still requires learning the hard way
• What’s next for healthcare providers, healthcare investors, and healthcare attorneys

Produced by Buttaci, Leardi & Werner, this episode is less about nostalgia and more about longevity – what holds up over time, what falls apart, and what’s worth carrying forward in healthcare law and business.

Join Almost Clinical hosts Vincent Buttaci, John Leardi, and Paul Werner as they challenge each other’s views on how to operate, invest, and succeed in healthcare’s rapidly shifting landscape, translate legalese into business sense for healthcare providers, executives, private equity professionals, and strategic stakeholders, and explore the issues shaping the business of medicine today and tomorrow.

In the latest episode of Almost Clinical, hosts and healthcare attorneys Vincent Buttaci, John Leardi, and Paul Werner dissect the Eliminating Kickbacks in Recovery Act (EKRA) and what the recent Ninth Circuit decision means for behavioral health providers, labs, and investors.

EKRA isn’t just another compliance acronym – it’s the law that upended how behavioral health operators, treatment facilities, and clinical labs market and grow their businesses. What began as Congress’s response to rampant patient-brokering and kickback schemes has evolved into one of the broadest and most unforgiving enforcement tools in healthcare.

Vincent, John, and Paul explain how EKRA expanded beyond the Anti-Kickback Statute, why “creative” inducements can now carry criminal risk, and how the Ninth Circuit’s decision made it clear that third-party marketers and investors are not immune. They also dig into real-world scenarios – from “free” flights and charitable donations to commission-based pay – that illustrate just how easy it is to step over the line.

Listeners will learn:

• How EKRA closed the loopholes left by the Anti-Kickback Statute;
• Why behavioral health became ground zero for kickback enforcement;
• What the Ninth Circuit’s ruling changes for marketers and investors;
• Why “intent” won’t protect you when enforcement comes calling;
• How free housing, charitable donations, and profit sharing can cross the line;
• What whistleblowers and DOJ pilot programs mean for operators;
• Practical strategies for staying compliant without killing your business, and so much more.

Please note that this episode discusses various forms of addiction and substance abuse facilities/programs. If you or someone you know is struggling with addiction, don’t be afraid to ask for help. Please contact ReachNJ at 844.732.2465 or reachnj.gov. Someone will be there to listen.

Produced by Buttaci, Leardi & Werner, the healthcare law boutique helping providers and investors navigate what’s legal, what’s risky, and what’s next.

Join Almost Clinical hosts Vincent Buttaci, John Leardi, and Paul Werner as they challenge each other’s views on how to operate, invest, and succeed in healthcare’s rapidly shifting landscape, translate legalese into business sense for healthcare providers, executives, private equity professionals, and strategic stakeholders, and explore the issues shaping the business of medicine today and tomorrow.

Almost Clinical returns with a sharp look at what happens when physicians and other licensed healthcare providers trade ownership for employment. Buttaci Leardi & Werner healthcare attorneys and show hosts Vincent Buttaci, John Leardi, and Paul Werner unpack the realities of a profession where nearly 8 out of 10 physicians now work as employees.

This episode cuts through the clichés and legalese to explore what really changes when the person who once ran the practice is suddenly answering to hospital administrators, private equity-backed groups, or “helpful” management companies. From exit deals to employment contracts to the not-so-small matter of clinical autonomy, the conversation moves fast, goes deep, and leaves no stone unturned.

Whether you’re a physician contemplating an offer, a healthcare provider navigating institutional protocols, or an investor evaluating practice acquisitions, Physicians as Employees: Autonomy, Exit Strategies, and the New Healthcare Economy offers important insights you won’t find in glossy recruitment brochures.

Listeners will learn:

• Why physician employment is now the dominant model and how we got here
• The hidden challenges when seasoned practice owners become employees again
• How private equity and hospital system acquisitions reshape autonomy, protocols, and practice culture
• The importance of due diligence: what every physician should ask before signing an employment contract
• How compensation models like work RVUs, KPIs, and restrictive covenants can make or break a deal
• Why knowing yourself – and trusting your instincts – matters more than any data point

BONUS: Get the lowdown on the tried-and-true “buffet principle” for reading contracts (hint: don’t fill up on the front-page perks).

Join Almost Clinical hosts Vincent Buttaci, John Leardi, and Paul Werner as they challenge each other’s views on how to operate, invest, and succeed in healthcare’s rapidly shifting landscape, translate legalese into business sense for healthcare providers, executives, private equity professionals, and strategic stakeholders, and explore the issues shaping the business of medicine today and tomorrow.