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.