Document:

<PAGE>

                                                                   EXHIBIT 10.24

                              FIRST AMENDMENT TO
                   FIRST AMENDED AND RESTATED LOAN AGREEMENT

     This First Amendment to First Amended and Restated Loan Agreement
("Amendment") is entered into as of the 30th day of April, 1998 by and between
PHYSICIANS RESOURCE GROUP, INC. ("Borrower"), a Delaware corporation, and
NATIONSBANK OF TENNESSEE, N.A., as a Lender and in its capacity as Agent
("Agent").

                               R E C I T A L S:

     WHEREAS, Lender, Agent and Borrower have previously entered into that First
Amended and Restated Loan Agreement (the "Loan Agreement") dated as of November
28, 1997; and

     WHEREAS, the parties wish to amend the Loan Agreement in certain respects
as to evidence the occurrence of the "Additional Closing," as defined therein;

     NOW, THEREFORE, for valuable consideration, the receipt and sufficiency of
which are acknowledged, the parties agree as follows:

     1.   Capitalized terms not otherwise defined herein shall have the meanings
set forth in the Loan Agreement.

     2.   The Loan Agreement is hereby amended by adding the following
definition to Article I thereof:

     "Consolidated Net Worth" means shareholders' equity, determined on a
     consolidated basis according to GAAP, as of the last day of each fiscal
     quarter.

     3.   The Loan Agreement is hereby amended by revising the definition of
"Maturity Date" in Article I thereof to provide in full as follows:

          "Maturity Date" means December 31, 1998. The Maturity Date may be
     extended from time to time by the written agreement of all Lenders, Agent
     and Borrower.

     4.   The Loan Agreement is hereby amended by revising Section 2.1 thereof
to provide in full as follows:

          2.1  Amount of Revolving Credit Loan. The principal indebtedness of
               -------------------------------
     Borrower to Lenders under the Revolving Credit Loan shall not exceed
     Fourteen Million and no/100 Dollars ($14,000,000.00) through September 30,
     1998, and Nine Million Five Hundred Thousand and No/100 Dollars
     ($9,500,000.00) thereafter, in each case less the amount of any permanent
     reductions of the

<PAGE>

     Revolving Credit Loan arising from the sale of assets pursuant to
     Section 6.10 hereof.

     5.   The Loan Agreement is hereby amended by deleting the definition of
"Additional Closing" in Article I thereof, by deleting Sections 2.17 and 3.3, by
replacing the present text of Section 5.3.13 with the sentence "This Section is
intentionally left blank" and by adding a Section 3.2.7 providing in full as
follows:

          3.2.7   Additional Conditions. Borrower shall have satisfied all of
                  ---------------------
     the conditions set forth in that First Amendment to First Amended and
     Restated Loan Agreement dated as of April 30, 1998 executed by Borrower and
     by NationsBank as Agent and as a Lender.

     6.   The Loan Agreement is hereby amended by adding a new Section 5.3.15
thereof, providing in full as follows:

          5.3.15  Default Notices from Providers. Borrower shall promptly
                  ------------------------------
     forward to Agent as received copies of any and all notices of default and
     of complaints commencing litigation received by any Borrower Entity with
     respect to Service Agreements.

     7.   The Loan Agreement is hereby amended by adding a second sentence to
Section 5.23 thereof, as follows:

     All Borrower Entities that are guarantors of the Obligations shall further
     grant a security interest to Agent for the benefit of Lenders in all of
     such guarantors' accounts and general intangibles, including, but not
     limited to, Service Agreements, and all proceeds thereof, to secure the
     Obligations, subject only to Permitted Encumbrances.

     8.   The Loan Agreement is hereby amended by revising Section 5.24 thereof
to provide in full as follows:

          5.24    Diagnostic Examinations. Borrower will assist Agent in the
                  -----------------------
     performance of diagnostic examinations of Borrower's systems, procedures,
     trade payables, receivables, treasury systems and other such matters as
     Lenders may require. The examinations shall be conducted by Agent's own
     personnel and shall be satisfactory to Agent as to scope and conclusions.
     Borrower shall pay all costs of the examinations, including charges for
     time spent by Agent's personnel and all travel and related expenses;
     provided, however, Borrower's financial responsibility for each examination
     shall not exceed $15,000 plus travel and other out of pocket expenses. The
     examinations will be completed by December 31, 1997 and by May 31, 1998,
     respectively.

                                      -2-
<PAGE>

     9.   The Loan Agreement is hereby amended by replacing the first two
sentences of Section 6.2 thereof with the following sentence:

          6.2  Borrower shall not allow or suffer any change of management
     whereby Richard A. Gilleland would cease serving as Chief Executive
     Officer, Peter G. Dorflinger would cease serving as President and Chief
     Operating Officer, Richard J. D'Amico would cease serving as Executive Vice
     President and General Counsel, Jonathan R. Bond would cease serving as
     Senior Vice President - ASC Operations, Michael Yeary would cease serving
     as Senior Vice President - Practice Operations, or Pamela B. Westbrook
     would cease serving as Vice President and Chief Financial Officer.

     10.  The Loan Agreement is hereby amended by revising Section 6.10 thereof
to provide in full as follows:

          6.10   Further Acquisitions, Mergers, Asset Sales, Etc.  Except for
                 -----------------------------------------------
     transactions involving only Borrower Entities, no Borrower Entity shall
     enter into any agreement to merge, consolidate, or otherwise reorganize or
     recapitalize, or sell, assign, lease, or otherwise dispose of (whether in
     one transaction or in a series of transactions) all or substantially all of
     their Property (whether now owned or hereafter acquired), except that
     during 1998, the Borrower Entities may dispose of assets without further
     approval from Lenders or Agent, provided that (i) the gross proceeds of
     such dispositions does not exceed One Million and No/100 Dollars
     ($1,000,000.00) in the aggregate, (ii) all such dispositions are reported
     to Agent in writing as they occur, and (iii) seventy-five percent (75%) of
     the gross proceeds of such dispositions are paid to Agent for the benefit
     of Lenders upon the closing of the dispositions as permanent reductions in
     the availability under the Revolving Credit Loan. Any additional
     dispositions of assets must be approved by Agent in writing. If Agent
     elects, in its discretion, to permit any such additional disposition, Agent
     may require that some or all of the proceeds thereof serve as further
     permanent reductions of availability under the Revolving Credit Loan.

     11.  The Loan Agreement is hereby amended by revising Section 6.12 thereof
to provide in full as follows:

          6.12   Disposition of Assets. No Borrower Entity shall dispose of any
                 ---------------------
     of its assets other than as permitted in Section 6.10 of this Agreement.

     12.  The Loan Agreement is hereby amended by revising the text of Article
VII thereof to provide in full as follows:

          7.1    Consolidated EBITDA. Borrower shall maintain at least Ten
                 -------------------
     Million and No/100 Dollars ($10,000,000.00) of Consolidated EBITDA for

                                      -3-
<PAGE>

     each fiscal quarter (less the most recent quarterly contribution to
     Consolidated EBITDA arising from assets that are disposed of as permitted
     under Section 6.10 of this Agreement after April 30, 1998).

             7.2  Consolidated Net Worth. Borrower shall maintain a Consolidated
                  ----------------------
     Net Worth equal to Borrower's Consolidated Net Worth as reported in its
     audited financial statements as of December 31, 1997 (which net worth, as
     reported, shall be at least $250,000,000), less $25,000,000, and increased
     by 75% of net income earned after December 31, 1997, without adjustment for
     losses.

     13.     The Loan Agreement is hereby amended by revising the text of
Section 8.1.10 thereof to provide in full as follows:

     8.1.10  Default on Other Funded Debt.  Any Borrower Entity's failure to
             ----------------------------
     make any payment on any Funded Debt when due or, if later, within any
     period of grace or cure permitted by the applicable documents, or the
     occurrence of any Event of Default under any obligation to any Affiliate of
     NationsBank.

     14.     The Loan Agreement is hereby amended by revising Exhibit 2.3
thereof to provide as set forth in Exhibit 2.3 hereto.

     15.     Concurrently with the execution and delivery of this Amendment,
Borrower shall deliver to Lender the following documents, all of which shall be
in form and substance acceptable to Lender and its counsel:

             a.   This Amendment.

             b.   Second Consolidated, Amended and Restated Revolving Credit
Note executed by Borrower.

             c.   Security Agreement executed by Borrower and by all Borrower
Entities that are guarantors of the Obligations.

             d.   UCC-1 Financing Statements executed by each of the Borrower
Entities that are parties to the Security Agreement for filing in such
jurisdictions as Agent may require.

             e.   First Amended and Restated Unconditional Limited Guaranty
executed by each of David Meyer, M.D. and Lucius E. Burch III.

             f.   Certification of Organizational Chart executed on behalf of
Borrower.

             g.   Certificates of Existence for Borrower and for each Borrower
Entity signing the Security Agreement.

                                      -4-
<PAGE>

          h.   Certified Copies of Resolutions issued by the Secretaries of each
Borrower Entity executing the Security Agreement, providing (i) that the
corporate charters and bylaws thereof have not been revised since last certified
to Lender, and (ii) confirming the adoption of resolutions authorizing the
execution and delivery of the Security Agreement.

          i.   Opinion Letter of Borrower's outside counsel addressing such
matters as Lender may require.

          j.   Evidence that documentation satisfactory to NationsBank of Texas,
N.A. has been entered into regarding its credit with respect to the Mann Berkley
Eye Center, P.A.

          k.   Evidence of payment of all expenses due in connection with the
closing of the transactions described in this Amendment.

     16.  Lender shall request UCC searches after the recordation of the above-
referenced financing statements.  The expense of obtaining these searches and
the legal fees and expenses incidental thereto shall be paid by Borrower upon
demand.  If the searches disclose any encumbrances other than those permitted
under the terms of the Security Agreement referenced above, Agent may declare an
Event of Default under the Loan Agreement.

     17.  Borrower shall pay all costs incidental to this Amendment, including,
but not limited to, the fees and expenses of Lender's and Agent's counsel and
all recording fees and taxes.

     18.  Borrower warrants and represents that (i) the Loan Documents are
valid, binding and enforceable against the applicable Borrower Entities
according to their terms, subject to principles of equity and laws applicable to
the rights of creditors generally, including bankruptcy laws, (ii) all
warranties and representations made by Borrower in the Loan Documents are hereby
again warranted and represented to be true as of the date hereof, except with
regard to matters expressed only as of a specific time or which have been
supplemented or superseded by disclosures to Agent and Lenders made in writing,
and (iii) no Unmatured Default or Event of Default presently exists under the
Loan Documents.  Borrower further acknowledges that Borrower's obligations
evidenced by the Loan Documents are not subject to any counterclaim, defense or
right of setoff, and Borrower hereby releases Lender from any claim, known or
unknown, that Borrower may have against Lender as of the execution of this
Agreement.

     19.  As amended hereby, the Loan Agreement remains in full effect, and all
agreements among the parties with respect to the subject hereof are represented
fully in this Amendment and the other written documents among the parties.  The
provisions of the Loan Agreement regarding arbitration of disputes and other
general matters also govern this Amendment.  THE VALIDITY, CONSTRUCTION AND
ENFORCEMENT HEREOF SHALL BE DETERMINED ACCORDING TO THE SUBSTANTIVE LAWS OF THE
STATE OF TENNESSEE.  This Amendment may be executed in counterparts, each of
which shall constitute an original hereof.

                                      -5-
<PAGE>

          Executed as of the date first written above.

                              PHYSICIANS RESOURCE GROUP, INC.,
                              a Delaware corporation, as Borrower

                              By: /s/ Richard J. D'Amico
                                  -----------------------------------------

                              Title: Executive Vice President
                                     --------------------------------------

                              NATIONSBANK OF TENNESSEE, N.A.,
                              a national banking association, as a Lender and as
                              Agent

                              By:  /s/ Elizabeth L. Knox
                                   ----------------------------------------
                                   Elizabeth L. Knox, Senior Vice President

                                      -6-<PAGE>

                                                                   EXHIBIT 10.25
                                                                   -------------

________________________________________

In the Matter of the Arbitration

         Between                             No. 70-160-0039698

PETER G. DORFLINGER

         - and -

PHYSICIANS RESOURCE GROUP, INC.
________________________________________

                      COMPROMISE AND SETTLEMENT AGREEMENT
                      -----------------------------------

     This Compromise and Settlement Agreement (the "Agreement") is entered into
by and between Movant Peter G. Dorflinger ("Dorflinger") and Respondent
Physicians Resource Group, Inc. ("PRG"). Dorflinger and PRG are sometimes
collectively referred to herein as the "Parties".

     WHEREAS, on or about November 24,1998, Dorflinger filed a demand for
arbitration with the American Arbitration Association under case no. 70-160-
0039698 (the "Arbitration"), seeking monetary damages alleged to be due and
owing to him pursuant to the Parties' written January 24, 1998 Employment
Agreement (the "Employment Agreement"); and

     WHEREAS, Dorflinger and PRG deny the respective allegations made in the
Arbitration by the other concerning the Employment Agreement and otherwise; and

     WHEREAS, the Parties desire to buy peace and to compromise and settle all
remaining past, present and future claims by and between them which were or
could have been brought in any forum or jurisdiction including in the
Arbitration related to the Employment Agreement;

     NOW, THEREFORE, in consideration of the mutual covenants of the Parties and
for other good and valuable consideration, the receipt and sufficiency of which
is hereby acknowledged, it is

                                                                        Page -1-
<PAGE>

agreed by and between the Parties as follows:

     1.   Basis. The foregoing recitals are true and correct and constitute the
          -----
basis for this Agreement.

     2.   Payment. PRG agrees to pay Dorflinger the total sum of FOUR HUNDRED
          -------
TWENTY FIVE THOUSAND ($425,000.00) DOLLARS on the following terms:

     a)   An initial payment of $200,000.00 shall be paid on or before April 30,
          1999, unless the date of execution of this Agreement by Dorflinger is
          after April 22, 1999, in which case payment shall be made on the
          eighth (8th") day after its execution;

     b)   Thereafter, the principal balance of $225,000.00 shall be paid in nine
          (9) equal and consecutive monthly installments as follows:

                    Amount                   Due Date
                    ------                   --------

               1.   $25,000.00               May 15,1999
               2.   $25,000.00               June 15, 1999
               3.   $25,000.00               July 15, 1999
               4.   $25,000.00               August 15, 1999
               5.   $25,000.00               September 15, 1999
               6.   $25,000.00               October 15, 1999
               7.   $25,000.00               November 15, 1999
               8.   $25,000.00               December 15, 1999
               9.   $25,000.00               January 15, 2000

     c)   All installments not paid when due shall bear interest at the rate of
          eighteen (18%) per annum from the respective due date until paid.

     d)   All payments shall be made payable to Dorflinger and shall be remitted
          to the following address or any subsequent address of which Dorflinger
          notifies PRG in writing:

                                                                        Page -2-
<PAGE>

                             Peter G. Dorflinger
                             One Carolane Trail
                             Houston, Texas 77024

     e)   All installments under this Agreement shall be immediately due and
          payable upon (i) the failure of PRG to pay an installment when due and
          the failure of PRG to cure such nonpayment within three (3) days of
          its receipt or five (5) days after transmittal of written notice from
          Dorflinger of such nonpayment or (ii) the closing of the sale of
          substantially all of the assets of PRG's surgery centers to AmSurg,
          Inc. or other strategic partners.

     3.   Release. Upon the terms, and subject to the conditions of this
          -------
Agreement, Dorflinger and PRG, for themselves and their respective current and
former agents, employees, legal representatives, heirs, successors, assigns,
directors, officers, attorneys and all persons, natural or corporate, in privity
with them, expressly RELEASE, ACQUIT and forever DISCHARGE each other and their
respective current and former agents, employees, legal representatives, heirs,
predecessors, successors, assigns, directors, officers, attorneys and all
persons, natural or corporate, in privity with each, from any and all claims,
demands, responsibilities, obligations, liabilities and causes of action of
whatsoever nature, whether statutory (including, without limitation, the Age
Discrimination in Employment Act), in tort, or otherwise, whether known or
unknown, fixed or contingent, which either were brought or could have been
brought in the Arbitration or in any other forum or jurisdiction. Nothing in
this Agreement is intended to or shall release the Parties' obligations under
this Agreement.

     4.   Employee Acknowledgments. Dorflinger acknowledges and agrees as
          ------------------------
follows:

     a.   He has been given a period of at least twenty-one (2 1) days within
          which to consider

                                                                        Page -3-
<PAGE>

          this Agreement;

     b.   He would not be entitled to receive the settlement payment being
          offered to him but for his executing this Agreement to compromise and
          settle the disputes between the Parties;

     c.   He has been advised of his right to consult with an attorney regarding
          this Agreement, and has done so; and

     d.   He may revoke this Agreement at any time within seven (7) days after
          the date he signs it by providing written notice of revocation to
          Phillip R. Jones no later than the seventh day after signing it.

     5.   No Admission of Liability. The Parties understand, acknowledge and
          -------------------------
agree that this Agreement constitutes a compromise of disputed claims and is not
to be construed as an admission of liability on the part of either party.

     6.   Representation of Ownership of Claims. Each of the Parties represents
          -------------------------------------
and warrants, which representations and warranties are, in part, consideration
for the execution of this Agreement, the following:

          (i)    such party owns all and each of the claims, rights, demands and
                 causes of action which such party is hereby releasing;

          (ii)   such party has not assigned to any other person or entity all
                 or any part of the party's claims, rights, demands or causes of
                 action; and

          (iii)  such party has the authority to execute this Agreement.

     7.   Agreement to Execute Necessary Documents. The Parties further agree,
          ----------------------------------------
upon demand, to execute, acknowledge and deliver any and all documents and to do
such other acts and things which are reasonably necessary to accomplish the
purposes of this Agreement.

                                                                        Page -4-
<PAGE>

     8.   Amendments. This Agreement may be amended only by an instrument in
          ----------
writing, executed by the Parties, and may be supplemented only by documents
delivered in accordance with the express terms hereof.

     9.   Notices. All notices to the Parties shall be deemed to have been duly
          -------
given if delivered personally, or mailed, postage prepaid, registered or
certified to the following addresses, or at such other addresses as the Parties
may designate in writing from time to time in the future:

                    If to Dorflinger:   Peter G. Dorflinger
                                        c/o Robert J. Ffrench, Esq.
                                        Law Offices of Robert J. Ffrench
                                        952 Echo Lane, Suite 180
                                        Houston, Texas 77024

                    If to PRG:          Physicians Resource Group, Inc.
                                        14800 Landmark Drive
                                        Dallas, Texas 75240-7565

                    With copy to:       Phillip R. Jones, Esq.
                                        Jackson Walker, L.L.P.
                                        901 Main Street, Suite 6000
                                        Dallas, Texas 75202

     10.  Entire Agreement. The Parties acknowledge that they have carefully
          ----------------
read this Agreement, that this Agreement expresses the entire agreement between
them concerning resolution of the Arbitration, as well as all other current or
potential claims and that each party has executed this Agreement freely and of
its and his own accord. The Parties acknowledge and agree that there are no
verbal or oral agreements between them relating to the settlement covered by
this Agreement. The terms hereof are contractual and not mere recitals.

     11.  Time of the Essence. Time is of the essence to the performance of the
          -------------------
terms of this Agreement.

     12.  Joint Preparation. This Agreement has been prepared by the joint
          -----------------
efforts of the

                                                                        Page -5-
<PAGE>

Parties and their counsel and is intended to be interpreted fairly and simply
and not strictly for or against either party. Each party acknowledges that it
has been provided with an opportunity to consult with legal counsel or any other
advisors, that it deems appropriate to the extent desired by such party.

     13.  Governing Law. This Agreement shall be construed and enforced in
          -------------
accordance with the laws of the State of Texas.

     14.  Venue. Venue for the resolution of any dispute arising from this
          -----
Agreement shall be in any court of competent jurisdiction in Harris County,
Texas.

     15.  Severability. If any provision of the Agreement is or may be held by
          ------------
a court of competent jurisdiction to be invalid, void or unenforceable, the
remaining provisions shall nevertheless survive and continue in full force and
effect without being impaired or invalidated in any way.

     16.  Multiple Originals. This instrument is executed in multiple originals.
          ------------------

     17.  Own Volition. The Parties further state that each of them has
          ------------
carefully read the foregoing Agreement and knows the contents thereof and has
signed the same as their own free act.

     18.  Binding Effect. This Agreement shall inure to the benefit of and be
          --------------
binding upon the respective successors and assigns of each of the Parties.

     19.  Adoption by Panel. The Parties hereby request that the three
          -----------------
arbitrators comprising the panel in the Arbitration (the "Panel") sign this
Agreement adopting its terms as the Panel's final and binding award or judgment
as those terms are contemplated or used in Section 11 of the Employment
Agreement. This Agreement may be entered and enforced by any court having
jurisdiction as a judgment in accordance with the Employment Agreement, the
Texas General

                                                                        Page -6-
<PAGE>

Arbitration Act, Section 171.002 et seq. of the Texas Civil Practice and
Remedies Code or the Federal Arbitration Act, 9 U.S.C. Section 1 et seq. The
Parties agree to expeditiously take any and all additional steps required by the
Panel to effectuate this Agreement as an award or judgment of the Panel.

     EXECUTED this,  22  day of April, 1999.
                    ----

                                             /s/ Peter G. Dorflinger
                                             -----------------------------------
                                             PETER G. DORFLINGER

                                             PHYSICIANS RESOURCE GROUP, INC.

                                             By:  /s/ Michael Yeary
                                                --------------------------------
                                             Its: President
                                                 -------------------------------

     Having received and understood the terms of this Agreement, I entered into
it on the terms and conditions expressed therein and waive any remaining period
of twenty-one (21) days allowed for my consideration of this Agreement.

                                             By:  /s/ Peter G. Dorflinger
                                                --------------------------------
                                             Date: April 22, 1999
                                                  ------------------------------

STATE OF TEXAS      (S)
                    (S)
                    (S)
COUNTY OF HARRIS    (S)

     This instrument was acknowledged before me on this the  22  day of April
                                                            ----
1999, by Peter G. Dorflinger.
                                             /s/ Tammy S. Adams
                                             -----------------------------------
                                             Notary Public - State of Texas

               TAMMY S. ADAMS
[STAMP] NOTARY PUBLIC, STATE OF TEXAS
            MY COMMISSION EXPIRES
               APRIL 16, 2000

                                                                        Page -7-
<PAGE>

STATE OF TEXAS      (S)
                    (S)
                    (S)
COUNTY OF HARRIS    (S)

     This instrument was acknowledged before me on this the  26  day of April,
                                                            ----
1999, by      Mike Yeary         ,   President         of Physicians Resource
         ------------------------  -------------------
Group, Inc., a Delaware corporation on behalf of said corporation.

                      JEU HUNG LIM           /s/ Jeu Hung Lim
          [STAMP] MY COMMISSION EXPIRES      -----------------------------------
                     APRIL 11, 2002          Notary Public - State of Texas

     We hereby adopt the terms of this Agreement as our award in Case No.
70-160-0039698, styled In the Matter of the Arbitration Between Peter G.
                       -------------------------------------------------
Dorflinger and Physicians Resource Group Inc. pending before the undersigned and
--------------------------------------------
as administered by the American Arbitration Association.

Arbitration Panel:

/s/ Lucretia Dillard
---------------------------------------
Lucretia D. Dillard, Esq. - Chairperson

/s/ Lynn Gomez
---------------------------------------
Lynn M. Gomez, Esq.

/s/ Robert C. Rice
---------------------------------------
Robert C. Rice, Esq.

                                                                        Page -8-

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