Opinion ID: 2026744
Heading Depth: 1
Heading Rank: 5

Heading: Enforceability of the Restrictive Covenants

Text: In opposition to defendants' motion for preliminary judgment, plaintiffs raised various affirmative defenses challenging the validity and enforceability of the restrictive covenants in their employment contracts. These claims were rejected by the courts below. Now, in their appeal before this court, plaintiffs argue once again that defendants are not entitled to a preliminary injunction to enforce the restrictive covenants in their employment contracts because the covenants are not enforceable. Plaintiffs affirmatively challenge the enforceability of the restrictive covenants, advancing three separate theories. First, they contend that all restrictive covenants in physician employment contracts should be held void and unenforceable because they are against the public policy of this state. Second, plaintiffs contend that defendants materially breached the employment contracts, thereby relieving plaintiffs of their obligations under the restrictive covenants. Third, plaintiffs contend that the restrictive covenants in their employment contracts may not be enforced because they are overly broad in their temporal and activity restrictions and, thus, unreasonable. We first address the contention that restrictive covenants in physician employment contracts should be held void as against public policy in Illinois. Initially, we note that this court has a long tradition of upholding the right of parties to freely contract. Vine Street Clinic v. Health-Link, Inc., 222 Ill.2d 276, 305 Ill.Dec. 617, 856 N.E.2d 422 (2006). Consequently, our decisions have held that a private contract, or provision therein, will not be declared void as contrary to public policy unless it is `clearly contrary to what the constitution, the statutes or the decisions of the courts have declared to be the public policy' or it is clearly shown that the contract is `manifestly injurious to the public welfare.' Vine Street Clinic v. HealthLink, Inc., 222 Ill.2d at 300, 305 Ill.Dec. 617, 856 N.E.2d 422, quoting Schumann-Heink v. Folsom, 328 Ill. 321, 330, 159 N.E. 250 (1927). See also Barr v. Kelso-Burnett Co., 106 Ill.2d 520, 88 Ill.Dec. 628, 478 N.E.2d 1354 (1985); Palmateer v. International Harvester Co., 85 Ill.2d 124, 52 Ill. Dec. 13, 421 N.E.2d 876 (1981) (the public policy of the state is to be found in its constitution and statutes and, when they are silent, then in its judicial decisions and constant practice of its governmental officials). We have strictly adhered to the position that the public policy of the state is not to be determined by `the varying opinions of laymen, lawyers or judges as to the demands of the interests of the public.' Groome v. Freyn Engineering Co., 374 Ill. 113, 124, 28 N.E.2d 274 (1940), quoting Zeigler v. Illinois Trust & Savings Bank, 245 Ill. 180, 193, 91 N.E. 1041 (1910). As a result, plaintiffs carry a heavy burden of showing that restrictive covenants in physician employment contracts are against the public policy of this state. In attempting to meet this burden, plaintiffs first point to our decision in Dowd & Dowd, Ltd. v. Gleason, 181 Ill.2d 460, 482, 230 Ill.Dec. 229, 693 N.E.2d 358 (1998), wherein we held that, in Illinois, restrictive covenants in attorney employment contracts are void as a matter of public policy. Citing to the appellate court decision in Carter-Shields v. Alton Health Institute, 317 Ill.App.3d 260, 250 Ill.Dec. 806, 739 N.E.2d 569 (2000), plaintiffs argue that the public policy reasons for finding restrictive covenants in physician employment contracts void are even more compelling than the reasons advanced with respect to attorney employment contracts. Plaintiffs provide a laundry list of the possible adverse effects of allowing restrictive covenants in physician employment contracts, namely, that restrictive covenants in physician employment contracts interfere with the doctor-patient relationship, deny patients the freedom to choose their own doctor, create barriers to the delivery of quality medical care, hinder competition, and often force patients to incur the additional expense of duplicative testing. In addition to these patient concerns, plaintiffs argue that restrictive covenants place unreasonable limits on physicians' autonomy and freedom of movement. Plaintiffs conclude that our decision in Dowd & Dowd and the appellate court decision in Carter-Shields provide a strong foundation upon which to find that covenants restricting skilled professionals from practicing their trade are contrary to the public policy of this state. We disagree. The appellate decision in Carter-Shields, upon which plaintiffs primarily rely, was vacated by this court in Carter-Shields v. Alton Health Institute, 201 Ill.2d 441, 268 Ill.Dec. 25, 777 N.E.2d 948 (2002), and, as such, carries no precedential weight. Moreover, the appellate decision in Carter-Shields stands alone in its rejection of long-standing Illinois precedent on the validity of restrictive covenants in physician employment contracts. See Prairie Eye Center, Ltd. v. Butler, 329 Ill.App.3d 293, 263 Ill.Dec. 654, 768 N.E.2d 414 (2002). Moreover, in Dowd, our determination that noncompetition covenants in attorney employment contracts were void was grounded in the fact that such covenants were in direct conflict with Rule 5.6 of the Illinois Rules of Professional Conduct, which gave expression to important considerations of public policy. Dowd, 181 Ill.2d at 481-83, 230 Ill.Dec. 229, 693 N.E.2d 358. Thus, we held, it would be inimical to public policy to give effect to the offending provisions. Dowd, 181 Ill.2d at 482-83, 230 Ill.Dec. 229, 693 N.E.2d 358. In the present case, there are no similar expressions of public policy which require us to find restrictive covenants in the employment contracts of medical practitioners unenforceable in Illinois. Plaintiffs, however, direct our attention to an opinion of the AMA's Council on Ethical and Judicial Affairs, which states: Covenants-not-to-compete restrict competition, disrupt continuity of care, and potentially deprive the public of medical services. The Council of Ethical and Judicial Affairs discourages any agreement which restricts the right of a physician to practice medicine for a specified period of time or in a specified area upon termination of an employment, partnership, or corporate agreement. Restrictive covenants are unethical if they are excessive in geographic scope or duration in the circumstances presented, or if they fail to make reasonable accommodation of patients' choice of physician. (Emphasis added.) AMA Council on Ethical and Judicial Affairs, Op. E-9.02 (1998). Plaintiffs contend that AMA Opinion 9.02 provides the necessary expression of public policy which would permit us to invalidate restrictive covenants in physician employment contracts. Again, we must disagree. AMA Opinion 9.02, while informative, is not the equivalent of an Illinois statute or rule of professional conduct and, for that reason, does not provide a clear expression of the public policy of this state. Thus, AMA Opinion 9.02 cannot dictate the manner in which restrictive covenants should be construed in Illinois. That having been said, we point out that Opinion 9.02 does not prohibit, but merely discourages, restrictive covenants in medical employment contracts. Furthermore, the AMA's position on restrictive covenants, as set forth in Opinion 9.02, is commensurate with the manner in which restrictive covenants in physician employment contracts are treated in this state. Historically, covenants restricting the performance of medical professional services have been held valid and enforceable in Illinois as long as their durational and geographic scope are not unreasonable, taking into consideration the effect on the public and any undue hardship on the parties to the agreement. Cockerill v. Wilson, 51 Ill.2d 179, 183-84, 281 N.E.2d 648 (1972); Canfield v. Spear, 44 Ill.2d 49, 254 N.E.2d 433 (1969). Thus, the AMA provision is no different from the common law requirements of this state. See Idbeis v. Wichita Surgical Specialists, P.A., 279 Kan. 755, 112 P.3d 81 (2005) (AMA requirements are no different from common law requirement that restrictive covenants be reasonable and not adverse to the public welfare). We are similarly unpersuaded by plaintiffs' references to other jurisdictions. Plaintiffs contend that states such as Colorado, Delaware and Massachusetts have concluded that physician restrictive covenants violate public policy. What they fail to acknowledge, however, is that in Colorado, Delaware, and Massachusetts restrictive covenants in medical employment contracts are totally prohibited based on legislative enactments. Plaintiffs' citation to Murfreesboro Medical Clinic, P.A. v. Udom, 166 S.W.3d 674, 681 (Tenn.2005), is similarly flawed. Plaintiffs claim that  Murfreesboro directly supports a holding by this court that physician restrictive covenants violate public policy. However, in Murfreesboro, the Supreme Court of Tennessee held a restrictive covenant unenforceable because noncompete covenants in physician employment contracts were, by statute, permitted in only two limited circumstances and with closely prescribed restrictions, which were inapplicable. While it is true that some jurisdictions prohibit restrictive covenants in physician employment contracts on public policy grounds, our research has been unable to reveal any case in which a court has altogether outlawed restrictive covenants in physician employment contracts in the absence of some legislative enactment. Moreover, the vast majority of jurisdictions follow the modern view, which is that restrictive covenants are enforceable if they are supported by consideration, ancillary to a lawful contract, and reasonable and consistent with the public interest. F. Tinio, Annotation, Validity and Construction of Contractual Restrictions on Right of Medical Practitioner to Practice, Incident to Employment Agreement, 62 A.L.R.3d 1014, 1020 (1975). Thus, the majority of jurisdictions employ the same reasonableness standard that this court has consistently applied when deciding the enforceability of restrictive covenants in medical employment contracts in Illinois. As stated earlier, when a party seeks to show that a contract term is against the public policy of this state, that party bears the burden of showing that the contract term is `clearly contrary to what the constitution, the statutes or the decisions of the courts have declared to be the public policy' or that the contract is `manifestly injurious to the public welfare.' Vine Street Clinic, 222 Ill.2d at 300, 305 Ill.Dec. 617, 856 N.E.2d 422, quoting Schumann-Heink v. Folsom, 328 Ill. 321, 330, 159 N.E. 250 (1927). In the case at bar, plaintiffs have failed to show that physician restrictive covenants are contrary to the constitution, statutes or judicial decisions of this state. Nor have they shown that these covenants are manifestly injurious to the public welfare. Although plaintiffs have offered reasons for finding that restrictive covenants should be disfavored in physician employment contracts, countervailing reasons exist which would militate against any deviation from our long-standing practice of finding reasonable restrictive covenants in medical employment contracts enforceable. Restrictive covenants protect the business interests of established physicians and, in this way, encourage them to take on younger, inexperienced doctors. Accordingly, restrictive covenants can have a positive impact on patient care. We do not know, and are ill-equipped to determine, what the possible consequences might be if we were to adopt the sweeping changes plaintiffs advocate. It is possible that patients would be more adversely affected if we were to ban reasonable restrictive covenants in physician employment contracts. For this reason, we believe that prohibiting restrictive covenants in medical practice contracts is a decision better left to the legislature, where the competing interests can be fully aired. Accordingly, plaintiffs' first claim is rejected. We now turn to plaintiffs' second claim  that a prior material breach of the employment contracts by defendants relieves them of their obligations under the restrictive covenants. Under general contract principles, a material breach of a contract provision by one party may be grounds for releasing the other party from his contractual obligations. William Blair & Co. v. FI Liquidation Corp., 358 Ill.App.3d 324, 294 Ill.Dec. 348, 830 N.E.2d 760 (2005). This principle was applied in Galesburg Clinic Ass'n v. West, 302 Ill.App.3d 1016, 1018, 236 Ill.Dec. 161, 706 N.E.2d 1035 (1999). In Galesburg, a medical association sought to enforce a noncompete covenant in the partnership agreement when two of the partners (defendants) quit. The defendants filed a counterclaim alleging that the association had breached the partnership agreement, discharging them of their duties under the covenant. The trial court ruled in the defendants' favor, finding a material breach by the association. On appeal, the appellate court affirmed, holding that a breach    can operate to discharge the duties of a covenant not to compete where the breach is material. See also C.G. Caster Co. v. Regan, 88 Ill.App.3d 280, 43 Ill.Dec. 422, 410 N.E.2d 422 (1980) (where one party materially breaches the contract, the restrictive covenant in the contract may no longer be binding on the other party). In the case at bar, plaintiffs ask us to apply the reasoning in Galesburg to this case. Initially, we note that, in the trial court, plaintiffs originally asserted that defendants breached the plaintiffs' employment contracts in a number of ways. However, after discovery was completed, plaintiffs restricted their argument to one claim  that defendants materially breached the employment contracts by improperly billing Medicare for myoview tests ordered by plaintiffs for their patients. The trial court rejected plaintiffs' claim, finding that the evidence presented by plaintiffs did not establish that defendants breached the employment contracts. The appellate court, having reversed the trial court's denial of the preliminary injunction on other grounds, refused to consider this issue, holding that plaintiffs must wait for a hearing on the merits. 358 Ill.App.3d at 910-11, 295 Ill.Dec. 490, 832 N.E.2d 940. Plaintiffs contend that the appellate court erred. According to plaintiffs, the appellate court ignored the fact that a full evidentiary hearing in the form of a trial was already held on the matter. Plaintiffs maintain that we must consider this claim because a determination on whether defendants breached the employment contracts is necessary to a decision on whether the restrictive covenants are enforceable. Plaintiffs also claim that the trial court's ruling on the matter of their breach-of-contract claim involved contract interpretation, which is an issue of law and, as a result, our review should be de novo. Defendants, on the other hand, initially argue that plaintiffs failed to appeal the trial court's adverse ruling on the breach-of-contract claim and, thus, have forfeited review of this issue. Putting aside forfeiture, defendants maintain that the trial court correctly determined that defendants did not materially breach the employment contracts. Defendants maintain, however, that the breach of contract issue is a question of fact and that, on review, we may not disturb the trial court's ruling unless it is against the manifest weight of the evidence. The overriding issue in the appeal at bar is the enforceability of the restrictive covenants in the employment contracts of Drs. Mohanty and Ramadurai. Because a prior breach of contract by defendants could render the restrictive covenants in the employment contracts unenforceable, we conclude that consideration of the breach of contract claim is necessary to our determination regarding the enforceability of the covenants. We agree with defendants that whether or not a material breach of contract has been committed is a question of fact and, consequently, the lower court's determination will not be disturbed unless it is against the manifest weight of the evidence. W.E. Erickson Construction, Inc. v. Congress-Kenilworth Corp., 115 Ill.2d 119, 104 Ill. Dec. 676, 503 N.E.2d 233 (1986); see also Borys v. Rudd, 207 Ill.App.3d 610, 152 Ill.Dec. 623, 566 N.E.2d 310 (1990). It is plaintiffs' position that defendants breached their employment contracts by failing to compensate plaintiffs the full amounts to which they were entitled under the provisions of their contracts. According to plaintiffs, they were significantly underpaid because of the manner in which defendants billed Medicare for myoview tests performed at the Clinic at plaintiffs' direction. The record shows that the myoview test (also known as a myocardial perfusion imaging study) is a diagnostic test used to determine whether the heart muscle is getting the blood supply it needs. The Clinic owned and maintained at its offices all of the equipment necessary to conduct myoview tests. The Clinic also had on its staff a trained technician who would administer the myocardial imaging phases of the tests. When conducting a myoview test, the Clinic's trained technician would first inject a small amount of radioactive isotope (thallium) into the patient's bloodstream and then take pictures of the patient using a special camera for the initial resting phase of the test. After the resting images were taken, the patient would take a stress test on a treadmill under the supervision of a physician. Thereafter, the technician would administer an additional injection to the patient and repeat the myocardial imaging process. The images would later be interpreted by the physician. [4] In regard to billing for the myoview test, Medicare assigned separate Current Procedural Terminology Codes (CPT Codes) for the technical and professional components of the test. According to defendants' expert witness, Janet Mazur, [5] the technical components of a procedure, billed under the TC CPT Code, are intended to cover overhead, technician salaries, equipment and equipment maintenance. See also Central States v. Pathology Laboratories of Arkansas, P.A., 71 F.3d 1251, 1252 (7th Cir.1995). The professional component of a procedure compensates the physician who interprets the test and is billed under the CPT Code 26. It is uncontested that when billing Medicare for myoview tests performed at the Clinic's offices, the technical components of the test were billed under Dr. Monteverde's name, while the professional component was billed under name of the physician who interpreted the test. Dr. Monteverde explained that he directed the billing for the technical component to be billed under his name to defray the costs of the initial $300,000 investment for the purchase of the myoview equipment, as well as remodeling costs necessary to accommodate the equipment. He further explained that Medicare's reimbursement for the technical component covered the salary of the licensed technician who administered the test, as well as the costs of medication, supplies and other overhead expenses associated with the test. Dr. Monteverde further testified that he believed it appropriate to bill the technical component under his name because he was the sole owner of the Clinic and the myoview testing equipment, as well as the person responsible for the training and supervision of the technician, who administered all of the myoview tests at the Clinic, regardless of which physician ordered the test. Plaintiffs, nevertheless, contend that Dr. Monteverde's billing procedure was improper. Specifically, plaintiffs argue that the technical component of the myoview test, which accounts for about 70% of the total cost of the test, was wrongly diverted to Dr. Monteverde and, thus, deprived them of compensation to which they were entitled under the terms of their employment contract. Plaintiffs' employment contracts provided that plaintiffs were to receive an annual salary of 50% of their gross receipts. [6] They maintain that their gross receipts should have been calculated based on the total cost of the myoview tests performed at the Clinic on their patients, not just the professional component. The employment contracts of Drs. Mohanty and Ramadurai provide: Employee shall be paid as follows for his work: 50% of his gross receipts. (Emphasis added.) At the hearings conducted by the trial court, defendants argued that the technical component of the myoview tests did not constitute Dr. Mohanty's or Dr. Ramadurai's work and, thus, there was no violation of the employment contract. It was necessary, therefore, for the trial court to resolve the question of whether the technical components of the myoview tests were part of plaintiffs' work. Plaintiffs proffered the testimony and report of an expert to support their contention that they were entitled to a share in the total amount charged to Medicare for the myoview test. However, defendants challenged the qualifications of plaintiffs' expert and the trial court barred this witness' testimony. As a result, plaintiffs position is largely unsupported. Defendants' expert, on the other hand, provided strong testimony in defense of defendants' billing practices. According to defendants' expert, Janet Mazur, billing for the technical component does not include any amounts for physician services. In a detailed report, Mazur explained the formulas used by Medicare to determine Physician Work Relative Value Units which is a reflection of a physician's work for a particular CPT Code. According to Mazur, the TC CPT Codes for the myoview test all carry a Physician Work Relative Value Unit of zero. Thus, Mazur concluded that the technical component of these tests, and corresponding payments for each component, does not encompass physician work. In light of the evidence presented by defendants' expert, we cannot say that it was against the manifest weight of the evidence for the trial court to determine that a material breach of contract was not established. We affirm the trial court's ruling on this matter and find that, because plaintiffs have not carried their burden of proving a breach of contract by defendants, plaintiffs have not shown why they should be relieved of their obligations under the restrictive noncompete covenants in their contracts. Accordingly, plaintiffs' breach-of-contract claim cannot serve as a basis upon which to deny defendants a preliminary injunction. Plaintiffs raise as their third and final issue whether the restrictive covenants in their employment contracts are unenforceable because they are unreasonably overbroad in their temporal and activity restrictions. The restrictive covenant in Dr. Ramadurai's contract imposed a three-year restriction on his practice of medicine within a two-mile radius of the Clinic's offices. The restrictive covenant in Dr. Mohanty's contract limited his ability to practice medicine for five years within a five-mile radius of the Clinic's offices. As noted earlier in this opinion, this court has a long tradition of upholding covenants not to compete in employment contracts involving the performance of professional services when the limitations as to time and territory are not unreasonable. Cockerill v. Wilson, 51 Ill.2d 179, 183-84, 281 N.E.2d 648 (1972); Canfield v. Spear, 44 Ill.2d 49, 254 N.E.2d 433 (1969); Bauer v. Sawyer, 8 Ill.2d 351, 134 N.E.2d 329 (1956). `In determining whether a restraint is reasonable it is necessary to consider whether enforcement will be injurious to the public or cause undue hardship to the promisor, and whether the restraint imposed is greater than is necessary to protect the promisee.' House of Vision, Inc. v. Hiyane, 37 Ill.2d 32, 37, 225 N.E.2d 21 (1967), quoting Bauer v. Sawyer, 8 Ill.2d 351, 355, 134 N.E.2d 329 (1956). The trial court, when considering the reasonableness of the covenants here, ruled that the activity restriction was unreasonably overbroad because the restriction on the practice of medicine was greater than necessary to protect the interests of defendants, who specialized in the practice of cardiology. The appellate court rejected this ruling, holding: Based on the testimony, it is not a greater restraint than necessary to protect the defendants. Dr. Ramadurai pointed out, as a doctor, he is licensed to practice medicine, not just his specialties. Just as Dr. Monteverde saw patients for conditions unrelated to internal medicine or cardiology, the plaintiffs' specialties do not prevent them from seeing patients in other areas of medicine, if they so chose, placing them in competition with the defendants. 358 Ill.App.3d at 908, 295 Ill.Dec. 490, 832 N.E.2d 940. In addition, the appellate court found that no undue hardship would accrue to plaintiffs as a result of the covenants because: They are free to practice medicine outside the five-mile limit, which, given the heavily populated Chicago metropolitan area, would not deprive them of employment. 358 Ill.App.3d at 908, 295 Ill.Dec. 490, 832 N.E.2d 940. Plaintiffs contest the correctness of the appellate court's ruling and ask us to affirm the circuit court's judgment on this point. We, however, find the appellate court's reasoning to be persuasive and, accordingly, affirm its ruling. Under the circumstances of this case, the restriction on the practice of medicine is not unreasonable. Cardiology, like other specialties, is inextricably intertwined with the practice of medicine. For this reason, restrictive covenants precluding the practice of medicine against physicians who practice a specialty have been upheld as reasonable. See Canfield v. Spear, 44 Ill.2d 49, 254 N.E.2d 433 (1969) (dermatologist); Prairie Eye Center, Ltd. v. Butler, 329 Ill.App.3d 293, 263 Ill.Dec. 654, 768 N.E.2d 414 (2002); Retina Services, Ltd. v. Garoon, 182 Ill.App.3d 851, 131 Ill.Dec. 276, 538 N.E.2d 651 (1989) (ophthalmologists). Thus, we find that the restraint on the practice of medicine, here, was not greater than necessary to protect defendants' interests. This is particularly so because the restriction on plaintiffs is in effect only within a narrowly circumscribed area of a large metropolitan area. As the appellate court noted, the two- and five-mile restrictions will not cause plaintiffs any undue hardship. Moreover, plaintiffs do not suggest that a more narrowly drawn activity restriction would have been practicable. Next, plaintiffs argue, as they did in the appellate court below, that the temporal restrictions found in their covenants are unreasonable and that the trial court held them to be so. Like the appellate court, however, we find plaintiffs' argument to be factually and substantively incorrect. The trial court found the temporal restrictions to be problematic. The trial court acknowledged that there was evidence in the record which would support a finding that the three- and five-year restrictions were reasonable, but then found it significant that Dr. Monteverde testified that the three-year restriction for Dr. Ramadurai just came into his mind and the five-year restriction was imposed on Dr. Mohanty because Dr. Monteverde did not trust him. It does not appear, however, that the trial court actually concluded that the temporal restrictions were unreasonable. In any event, we do not agree that Dr. Monteverde's candid remarks are cause for concern. Courts, when assessing the reasonableness of restrictive covenants, are to apply an objective standard, informed by the individual facts of the case. Thus, Dr. Monteverde's personal, subjective motivations for imposing the particular temporal restrictions are irrelevant as long as the limitations satisfy an objective standard of reasonableness. We find that they do. Record evidence indicated that it took more than 10 years for St. John Clinic to establish itself as a successful cardiology practice. Dr. Monteverde testified that it took a minimum of three to five years to develop a referral base and that during the time that Drs. Ramadurai and Mohanty worked for the Clinic, nearly all of their referrals had come through the Clinic. Further, Dr. Monteverde testified that from 1989, when Dr. Ramadurai was hired, to 2001, when Dr. Mohanty was hired, the practice of cardiology had become much more competitive. There were more cardiologists in the area, which meant that a greater number of doctors were available to serve a limited number of cardiology patients in the area. There is nothing to indicate that the trial court did not find Dr. Monteverde's testimony to be credible. More importantly, plaintiffs have never presented any evidence to refute it. We cannot say, therefore, that the three- and five-year restrictions are unreasonable under the circumstances of this case. We note, too, that similar restrictions in other restrictive covenants have been upheld as reasonable. Cockerill v. Wilson, 51 Ill.2d 179, 281 N.E.2d 648 (1972) (five-year restriction); Canfield v. Spear, 44 Ill.2d 49, 254 N.E.2d 433 (1969) (three years); Bauer v. Sawyer, 8 Ill.2d 351, 134 N.E.2d 329 (1956) (five-year restriction). Finally, plaintiffs argue that, with their absence from the Clinic, the Clinic will be unable to handle its patient load. This argument is unresponsive to the issue here  whether the temporal restriction is greater than necessary to protect defendants' interests. The measure of the potential harm to the public caused by the restriction is whether there exists a sufficient number of cardiologists in the area to meet patient needs. Plaintiffs do not contest defendants' evidence on this point. Thus, we cannot say that barring plaintiffs from the practice of medicine within the restricted area for the stated time periods would seriously diminish the number of cardiologists available to provide the necessary patient care. Therefore, we conclude that the three- and five-year time restrictions on the plaintiffs' ability to practice medicine within the limited geographical area was reasonable and necessary to protect the Clinic's interests.