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A lot can change in a practice over the course of a few years-the group's culture can shift, its financial standing may improve or decline, it may lose or gain physicians-and a practice may be setting itself up for financial or legal troubles if it doesn't keep its buy-sell agreement up to date to reflect these changes. Buy-sell agreements are the cornerstone of most private physician practices because they establish a process for bringing new owners on board and outline the financial and professional obligations of each member when a physician leaves the practice.