DOCTORS HEALTH SYSTEM INC
10-Q, 1997-03-10
MISC HEALTH & ALLIED SERVICES, NEC
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                                 UNITED STATES
                       SECURITIES AND EXCHANGE COMMISSION
                             WASHINGTON, D.C. 20549
                                   FORM 10-Q

        (MARK ONE)
        [X] QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE
            SECURITIES EXCHANGE ACT OF 1934
            FOR THE QUARTERLY PERIOD ENDED DECEMBER 31, 1996
                                   OR
        [ ] TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE
            SECURITIES EXCHANGE ACT OF 1934


                        COMMISSION FILE NUMBER: 333-1926
                          DOCTORS HEALTH SYSTEM, INC.
             (Exact name of registrant as specified in its charter)

                    MARYLAND                              52-1907421
(State or other jurisdiction of incorporation or       (I.R.S. Employer
                  organization)                      Identification No.)


                             10451 MILL RUN CIRCLE
                                   10TH FLOOR
                             OWINGS MILLS, MARYLAND
                                     21117

                    (Address of principal executive offices)
                                   (Zip Code)

                                 (410) 654-5800
              (REGISTRANT'S TELEPHONE NUMBER, INCLUDING AREA CODE)


     Indicate by check mark whether the registrant: (1) has filed all reports
required to be filed by Section 13 or 15(d) of the Securities Exchange Act of
1934 during the preceding 12 months (or for such shorter period that the
registrant was required to file such reports), and (2) has been subject to such
filing requirements for the past 90 days. Yes  X    No

     As of March 7, 1997 810,000 shares of the registrant's Class A Common stock
and 2,623,100 shares of the Registrant's Class B Common Stock were outstanding.

<PAGE>
                          DOCTORS HEALTH SYSTEM, INC.
                                   FORM 10-Q
                               DECEMBER 31, 1996
                               TABLE OF CONTENTS
<TABLE>
<CAPTION>
                                                                               PAGE
                                                                                NO.
<S> <C>
PART 1.     FINANCIAL INFORMATION
            Item 1. Unaudited Consolidated Financial Statements
                    Unaudited Consolidated Balance Sheets.....................   1
                    Unaudited Consolidated Statements of Operations...........   2
                    Unaudited Consolidated Statements of Cash Flows...........   3
                    Notes to Unaudited Consolidated Financial Statements......   4
            Item 2. Management's Discussion and Analysis of
                    Financial Condition and Results of Operations.............   7
PART II.    OTHER INFORMATION
            Item 4. Submission of Matters to a Vote of Security Holders.......   11
            Item 6. Exhibits and Reports on Form 8-K..........................   12
            SIGNATURES
</TABLE>

<PAGE>
                          DOCTORS HEALTH SYSTEM, INC.
                          CONSOLIDATED BALANCE SHEETS
                                  (UNAUDITED)
<TABLE>
<CAPTION>
                                                                                                         PRO FORMA
                                                                                           JUNE 30,      JUNE 30,     DECEMBER 31,
                                                                                             1996          1996           1996
                                                                                         ------------   -----------   ------------
<S> <C>
ASSETS
CURRENT ASSETS
  Cash and cash equivalents...........................................................   $  1,419,295   $ 1,419,295   $  2,883,049
  Accounts receivable (net of allowance for doubfful accounts of $324,521 at June 30,
    1996, and $440,000 at December 31, 1996, respectively)............................      1,303,941     1,303,941      1,845,079
  Accounts receivable-affiliates......................................................      1,208,685     1,208,685      1,377,102
  Other receivables...................................................................         64,251        64,251        456,873
  Prepaid expenses....................................................................        117,096       117,096        447,339
  Due from affiliates.................................................................        891,985       891,985      1,103,895
                                                                                         ------------   -----------   ------------
    TOTAL CURRENT ASSETS..............................................................      5,005,253     5,005,253      8,113,337
PROPERTY AND EQUIPMENT, NET...........................................................      2,485,547     2,485,547      3,087,829
OTHER ASSETS
  Intangibles (net of accumulated amortization of $65,170 at June 30, 1996 and
    $162,424 at
    December 31, 1996, respectively)..................................................      2,448,030     2,448,030      5,116,572
  Deferred charges (net of accumulated amortization of $147,475 at June 30, 1996 and
    $306,188 at December 31, 1996, respectively)......................................        636,772       636,772      1,235,115
  Note receivable.....................................................................        300,000       300,000             --
  Accrued interest receivable.........................................................        253,976       253,976        308,762
  Deposits............................................................................         24,560        24,560         60,817
                                                                                         ------------   -----------   ------------
                                                                                            3,663,338     3,663,338      6,721,266
                                                                                         ------------   -----------   ------------
    TOTAL ASSETS......................................................................   $ 11,154,138   $11,154,138   $ 17,922,432
                                                                                         ============   ===========   ============
LIABILITIES AND STOCKHOLDERS' EQUITY (DEFICIT)
CURRENT LIABILITIES
  Bridge Loan.........................................................................   $         --   $        --   $    983,017
  Notes Payable.......................................................................        303,915       303,915      3,605,689
  Current maturities of capital lease obligations.....................................        101,985       101,985        106,360
  Accounts payable....................................................................        330,647       330,647        638,969
  Accrued medical claims..............................................................        550,520       550,520      2,235,613
  Other accrued expenses..............................................................      2,069,579     2,069,579      2,392,781
  Due to affiliates...................................................................        766,475       766,475      1,413,884
                                                                                         ------------   -----------   ------------
    TOTAL CURRENT LIABILITIES.........................................................      4,123,121     4,123,121     11,376,313
LONG-TERM OBLIGATIONS
  Note payable........................................................................      3,400,000     3,400,000             --
  Notes payable and purchase obligations-related parties..............................      2,077,364     2,077,364      2,458,171
  Capital lease obligations, less current maturities..................................        320,673       320,673        265,575
                                                                                         ------------   -----------   ------------
                                                                                            5,798,037     5,798,037      2,723,746
COMMITMENTS AND CONTINGENCIES
REDEEMABLE CONVERTIBLE PREFERRED STOCK
  6.5% cumulative, Series A, $5 par value, authorized and issued 1,000,000 shares
    (liquidation value $3,500,000)....................................................      5,273,305     5,273,305      5,435,805
  Less subscription receivable-.......................................................     (1,500,000)   (1,500,000)    (1,500,000)
                                                                                         ------------   -----------   ------------
                                                                                            3,773,305     3,773,305      3,935,805
  9.75% cumulative, Series B, $11.25 par value, authorized and issued 355,556 shares
    (liquidation value $4,000,000)....................................................      4,137,526     4,137,526      4,332,548
  8% cumulative, Series C, $17.50 par value, authorized 1,071,428 shares; issued and
    outstanding 428,751 shares (liquidation value $7,500,000).........................             --            --      7,683,463
                                                                                         ------------   -----------   ------------
                                                                                            7,910,831     7,910,831     15,951,816
REDEEMABLE CLASS A COMMON STOCK
  $.01 per value, authorized, issued and outstanding 800,000 shares at June 30,
    1996..............................................................................      2,400,000            --             --
STOCKHOLDERS' EQUITY (DEFICIT)
  Preferred Stock, $.01 par value; authorized 1,000,000 shares, no shares issued......             --            --             --
  Common Stock
    Class A, $.01 par value; authorized 20,700,000 shares, issued and outstanding
     800,000 shares at December 31, 1996..............................................             --         8,000          8,000
    Class B, $.01 par value; authorized 10,000,000; issued and outstanding 2,398,000
     shares at June 30, 1996 and 2,552,000 at December 31, 1996.......................         23,980        23,980         25,520
    Class C, $.01 par value; authorized 29,050,000; no shares issued..................             --            --             --
    Additional paid in capital........................................................      2,323,600     2,323,798      4,117,268
    Retained earnings (accumulated deficit)...........................................    (11,425,431)   (9,033,629)   (16,280,231)
                                                                                         ------------   -----------   ------------
      TOTAL STOCKHOLDERS' EQUITY (DEFICIT)............................................     (9,077,851)   (6,677,851)   (12,129,443)
                                                                                         ------------   -----------   ------------
      TOTAL LIABILITIES AND STOCKHOLDERS' EQUITY (DEFICIT)............................   $ 11,154,138   $11,154,138   $ 17,922,432
                                                                                         ============   ===========   ============
</TABLE>

                See accompanying notes to financial statements.


                                       1

<PAGE>


                          DOCTORS HEALTH SYSTEM, INC.
                     CONSOLIDATED STATEMENTS OF OPERATIONS
                                  (UNAUDITED)
<TABLE>
<CAPTION>
                                                                           THREE MONTHS ENDED             SIX MONTHS ENDED
                                                                       DECEMBER 31,    DECEMBER 31,  DECEMBER 31,   DECEMBER 31,
                                                                           1995           1996          1995           1996
                                                                      -------------  -------------  -------------  -------------
<S> <C>
REVENUES
  Net revenue.....................................................    $   915,902    $ 2,705,841    $ 1,472,969    $ 4,900,352
  Capitation revenue..............................................             --      2,219,562             --      3,487,175
                                                                      -----------    -----------    -----------    -----------
                                                                          915,902      4,925,403      1,472,969      8,387,527
EXPENSES
  Medical services expense........................................             --      2,550,395             --      3,745,896
  Care center costs...............................................        837,452      2,696,243      1,323,703      4,799,762
  General and administrative......................................        850,635      3,184,390      1,386,750      5,854,470
  Depreciation and amortization...................................         94,310        288,693        144,855        513,077
                                                                      -----------    -----------    -----------    -----------
                                                                        1,782,397      8,719,721      2,855,308     14,913,205
                                                                      -----------    -----------    -----------    -----------
     Loss from operations.........................................       (866,495)    (3,794,318)    (1,382,339)    (6,525,678)
OTHER INCOME (EXPENSE)
  Interest and other income.......................................         39,950         68,767        111,755        137,805
  Interest expense................................................        (59,356)      (158,729)       (94,467)      (306,944)
                                                                      -----------    -----------    -----------    -----------
                                                                          (19,406)       (89,962)        17,288       (169,139)
                                                                      -----------    -----------    -----------    -----------
     Loss before income taxes.....................................       (885,901)    (3,884,280)    (1,365,051)    (6,694,817)
  Income taxes....................................................             --             --             --             --
                                                                      -----------    -----------    -----------    -----------
     NET LOSS.....................................................    $  (885,901)   $(3,884,280)   $(1,365,051)   $(6,694,817)
                                                                      ===========    ===========    ===========    ===========
  Loss applicable to common stock
     Net loss.....................................................    $  (885,901)   $(3,884,280)   $(1,365,051)   $(6,694,817)
     Preferred stock dividends accreted...........................        113,750        328,761        195,000        551,785
                                                                      ===========    ===========    ===========    ===========
     Loss applicable to common stock..............................    $  (999,651)   $(4,213,041)   $(1,560,051)   $(7,246,602)
                                                                      ===========    ===========    ===========    ===========
Net loss per share................................................         ($0.33)        ($1.27)        ($0.52)        ($2.22)
                                                                      ===========    ===========    ===========    ===========
Weighted average number of shares outstanding.....................      3,000,000      3,323,304      3,000,000      3,264,761
                                                                      ===========    ===========    ===========    ===========
</TABLE>

                See accompanying notes to financial statements.

                                       2
<PAGE>

                          DOCTORS HEALTH SYSTEM, INC.
                     CONSOLIDATED STATEMENTS OF CASH FLOWS
                                  (UNAUDITED)

<TABLE>
<CAPTION>
                                                                           THREE MONTHS ENDED             SIX MONTHS ENDED
                                                                       DECEMBER 31,    DECEMBER 31,  DECEMBER 31,   DECEMBER 31,
                                                                           1995           1996          1995           1996
                                                                      -------------  -------------  -------------  -------------
<S> <C>
CASH FLOWS FROM OPERATING ACTIVITY
  Net loss........................................................   $  (885,901)   $(3,884,280)   $(1,365,051)   $(6,694,817)
  Adjustments to reconcile net loss to net cash (used in) provided
     by operating activities
     Depreciation and amortization................................        94,310        288,693        144,855        513,077
     Provision for uncollectible accounts receivables.............        37,145         55,268         54,460        115,479
     Changes in assets and liabilities, net of effects of medical
       practice receivables acquired
       Accounts receivable........................................       202,197        476,997        261,906         85,550
       Accounts receivable -- affiliates..........................       (70,374)      (222,362)       (32,020)      (122,755)
       Prepaid expenses and other receivables.....................        (4,967)      (646,138)        10,879       (777,651)
       Due from/to affiliates.....................................       (71,013)       296,156       (648,761)       435,499
       Accounts payable...........................................      (360,448)       244,606        134,520        308,322
       Accrued and other liabilities..............................      (502,534)     1,426,787        381,896      1,611,999
       Organizational costs and deferred charges..................        (8,385)      (540,801)        (8,385)      (766,923)
                                                                     -----------    -----------    -----------    -----------
          Net cash (used in) provided by operating activities.....    (1,569,970)    (2,505,074)    (1,065,701)    (5,292,220)
CASH FLOWS FROM INVESTING ACTIVITIES
  Purchase of property and equipment..............................      (352,976)      (474,306)      (693,640)      (707,923)
  Payments for acquisition costs..................................        (6,514)      (592,373)        (9,354)      (823,114)
  Deposits........................................................       111,678         (9,589)       130,063        (36,257)
                                                                     -----------    -----------    -----------    -----------
          Net cash used in investing activities...................      (247,812)    (1,076,268)      (572,931)    (1,567,294)
CASH FLOWS FROM FINANCING ACTIVITIES
  Net proceeds from issuance of redeemable convertible preferred
     stock........................................................     3,910,000             --      4,410,000      7,489,200
  Borrowings under notes payable..................................            --             --             --      1,183,017
  Principal payments on capital lease obligations.................       (33,800)       (26,014)       (37,647)       (50,723)
  Payments on notes payable.......................................       (10,915)      (130,111)       (18,708)      (298,226)
                                                                     -----------    -----------    -----------    -----------
          Net cash provided by (used in) financing activities.....     3,865,285       (156,125)     4,353,645      8,323,268
          Net increase (decrease) in cash and cash equivalents....     2,047,503     (3,737,467)     2,715,013      1,463,754
Cash and cash equivalents at beginning of period..................       799,395      6,620,516        131,885      1,419,295
                                                                     -----------    -----------    -----------    -----------
Cash and cash equivalents at end of period........................   $ 2,846,898    $ 2,883,049    $ 2,846,898    $ 2,883,049
                                                                     ===========    ===========    ===========    ===========
SUPPLEMENTAL CASH FLOW INFORMATION
  Cash paid for interest..........................................   $    36,451    $    90,860    $    43,725    $   188,452
                                                                     ===========    ===========    ===========    ===========
  Cash paid for income taxes......................................   $        --    $        --    $        --    $        --
                                                                     ===========    ===========    ===========    ===========
</TABLE>

                See accompanying notes to financial statements.

                                       3
<PAGE>

                          DOCTORS HEALTH SYSTEM, INC.
              NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
          THREE MONTHS AND SIX MONTHS ENDED DECEMBER 31, 1996 AND 1995

NOTE 1 -- BASIS OF PRESENTATION

     The accompanying unaudited consolidated financial statements have been
prepared in accordance with generally accepted accounting principles of interim
financial reporting and in accordance with Rule 10-01 of Regulation S-X.
Accordingly, they do not include all of the information and notes required by
generally accepted accounting principles for complete financial statements.

     In the opinion of management, the unaudited interim financial statements
contained in this report reflect all adjustments, consisting of only normal
recurring accruals which are necessary for a fair presentation of the financial
position and the results of operations for the interim periods presented. The
results of operations for any interim period are not necessarily indicative of
results for the full year.

     The consolidated financial statements for the three months and six months
ended December 31, 1995 and 1996 are unaudited and should be read in conjunction
with the financial statements and the notes thereto included in the Company's
Amendment No. 7 to its S-1 Registration Statement for the year ended June 30,
1996.

NOTE 2 -- ACQUISITIONS

     The Company acquires certain assets of medical practices from Equity
Physicians and enters into long-term contracts with Core Medical Groups (CMG)
who employ the physicians. The Company currently derives a significant portion
of its total revenues pursuant to the Physician Services Organization Agreements
(PSO Agreement), which are long-term contracts between CMGs and the Company. The
Company's PSO Agreements have a 30-year term with an unlimited number of 10-year
renewals. Under the PSO Agreements, the Company provides general management,
billing and collection, office personnel, managed care contracting and care
management services. Under the PSO Agreements, the Core Medical Groups agree to
comply with the terms of managed care contracts, including the delivery of
health care services, 24-hour coverage, cooperation with utilization review,
quality assurance and peer review programs. The PSO Agreement does not convey
any equity interest in the CMGs, which retain autonomy and independence over
clinical matters.

     During the three months ended December 31, 1996, the Company acquired
certain assets of the medical practices of 16 physicians. In connection with the
transactions, the Company added 10 of the physicians to an existing CMG (Doctors
Health Montgomery, LLC) and 6 to a new CMG (Anne Arundel Medical Group, LLC).
During the three months ended December 31, 1995, the Company added 8 physicians
and expanded its Core Medical Groups from one to two. During the three months
ended December 31, 1996, the consideration paid for the acquisition of medical
practice assets totaled approximately $2,921,000 and consisted of 26% cash, 51%
stock and 23% notes payable and liabilities assumed. During the three months
ended December 31, 1995, the consideration paid for the acquisition of medical
practice assets totaled approximately $771,000 and consisted of 1% cash, 64%
stock and 35% notes payable and liabilities assumed.

NOTE 3 -- NET REVENUE

     The Company's net revenues represent the contractual management and similar
fees earned under its long-term PSO Agreements with CMGs. Under the PSO
Agreements, the Company is contractually responsible and at risk for the
operating costs of the CMGs with the exception of amounts retained by
physicians. The Company's net revenues include the reimbursement of all medical
practice operating costs and the contractual management fees as defined and
stipulated in the PSO Agreements. Contractual fees are accrued when collection
is probable. Revenue for all CMGs is recorded at established rates reduced by
allowances for doubtful accounts and contractual adjustments and amounts
retained by physician groups.

                                       4

<PAGE>

                          DOCTORS HEALTH SYSTEM, INC.
                   NOTES TO FINANCIAL STATEMENTS -- CONTINUED

NOTE 3 -- NET REVENUE -- Continued

     The following represents amounts included in the determination of net
revenue:

<TABLE>
<CAPTION>
                                                                          THREE MONTHS ENDED               SIX MONTHS ENDED
                                                                     DECEMBER 31,    DECEMBER 31,    DECEMBER 31,    DECEMBER 31,
                                                                         1995            1996            1995            1996
                                                                     ------------    ------------    ------------    ------------
<S> <C>
Gross physician revenue...........................................     2,557,561       7,820,725       4,289,050      13,704,635
  Less: Provision for contractual and other adjustments...........    (1,008,295)     (3,348,485)     (1,655,087)     (5,656,371)
Gatekeeper capitated income.......................................       295,299         775,063         453,777       1,392,504
                                                                      ----------      ----------      ----------      ----------
Net physician revenue.............................................     1,844,565       5,247,303       3,087,740       9,440,768
Amount retained by affiliated core medical groups:
  Physicians......................................................       775,724       2,490,249       1,374,564       4,324,966
  Ancillary employees and expenses................................       152,939          51,213         240,207         215,450
                                                                      ----------      ----------      ----------      ----------
Net revenue.......................................................       915,902       2,705,841       1,472,969       4,900,352
                                                                      ==========      ==========      ==========      ==========
</TABLE>

     During the three months ended December 31, 1995 and 1996, the Company
derived substantially all of its net revenue from two and five, respectively,
affiliated CMGs with which it has PSO agreements. For the three months ended
December 31, 1995 and 1996, one of these CMGs comprised approximately 99% and
69%, respectively, of the Company's net revenue respectively.

NOTE 4 -- CAPITATION REVENUE AND MEDICAL SERVICES EXPENSE RECOGNITION

     As of December 31, 1996, the Company has three global capitation contracts
and twelve gatekeeper capitation contracts with thirteen separate Health
Maintenance Organizations (HMOs). Under the contracts, the Company receives
monthly capitation fees based on the number of enrollees selecting any one of
the Company's affiliated primary care physicians. The capitation revenue under
these contracts is prepaid monthly based on the number of enrollees and is
recognized as capitation revenue during the month services are provided to the
enrollees. During the three months ended December 31, 1996, $1,572,229 and
$647,333, were recorded as global capitation and gatekeeper capitation revenue,
respectively, in the Company's financial statements. During the six months ended
December 31, 1996, $2,498,842 and $988,333, were recorded as global capitation
and gatekeeper capitation revenue, respectively, in the Company's financial
statements. During the three months and six months ended December 31, 1995, the
Company had no global or gatekeeper capitation contracts.

     The Company's commercial capitation contract also includes a provision
whereby the Company can earn additional incentive revenue or incur medical
services expenses based upon the enrollees' utilization of hospital services.
Estimated amounts receivable or payable from the HMO are recorded based upon
actual hospital utilization and associated costs incurred by assigned HMO
enrollees, compared to the portion of the commercial capitation fees allocated
for hospitalization. Differences between actual contract settlements and
estimated receivables or payables relating to the arrangement are recorded in
the year of settlement. Included in accrued medical services as of December 31,
1996 is approximately $95,000 of estimated amounts due to the HMO under this
arrangement.

     Under the Company's two Medicare full risk capitation contracts, the
Company has assumed responsibility for managing and paying for substantially all
of the medical care for the respective payor's enrollees. Consequently, the
Company does not perform a settlement with the HMOs under the two Medicare
contracts.

     The Company is responsible for the cost of the medical services provided by
its affiliated physicians and other providers who are covered under global
capitation contracts. The cost of medical services is recognized in the period
in which it is provided and includes an estimate of the cost of services which
have been incurred but not yet reported. The estimate for accrued medical
services is based on projections of costs using historical studies of claims
paid. Estimates are continually monitored and reviewed and, as settlements are
made or estimates are adjusted, differences are reflected in current operations.
As of December 31, 1996, approximately $2,140,000 was recorded as accrued
medical services for incurred but not reported services.

                                       5

<PAGE>

                          DOCTORS HEALTH SYSTEM, INC.
                   NOTES TO FINANCIAL STATEMENTS -- CONTINUED

NOTE 5 -- CAPITALIZATION

     On September 4, 1996, the Company issued 428,571 shares of Series C
Preferred Stock to Genesis Health Ventures, Inc. (Genesis), in exchange for
$7,500,000 in cash. See Subsequent Events below for a summary of the additional
investment by Genesis on January 2, 1997 and January 31, 1997.

NOTE 6 -- COMMON STOCK REPURCHASE AGREEMENT

     Under the terms of the stockholders' agreement with three founding
shareholders (who are also officers and directors of the Company), the Company
may be required to purchase shares of the Company's Class A Common Stock in
certain circumstances including death or disability. As of June 30, 1996, the
Company had obtained insurance to cover the purchase of the capital stock in the
event of death. On December 20, 1996, the Company obtained insurance to cover
the purchase of the capital stock in the event of a disability. By agreement
dated February 1, 1997, one of the founding shareholders agreed to waive the
repurchase agreement with respect to any disability not covered by insurance. As
of February 17, 1997, the insurance lapsed with respect to the founding
shareholder who waived the Company's obligation to purchase such founding 
shareholder's capital stock in the event of a disability. Under each of the
above policies, the Company has obtained insurance that is in excess of the
estimated fair value of its Class A Common Stock. In order to comply with
Article 5 of Regulation S-X, the Company has presented the common stock that is
redeemable based on events outside the Company's control (i.e. a disability) as
Redeemable Class A Common Stock in the accompanying Balance Sheet as of June
30, 1996. As a result of the coverage provided by the life and disability
policies described above and the waiver of certain stock repurchase rights
described above, there are no circumstances in which a redemption event would
result in a decrease in the Company's stockholders' equity. The Company will
present the Class A Common Stock as stockholders' equity in all balance sheets
subsequent to December 20, 1996. The Company has presented an unaudited Pro
Forma Balance Sheet as of June 30, 1996 assuming the Class A Common Stock is
covered by insurance for any event of redemption. The Company intends to
maintain insurance at levels sufficient to finance its redemption obligations.
The terms of the stock purchase agreement terminate in the event of an initial
public offering or a change in control of the Company as defined in the
stockholders' agreement with three founding shareholders.

NOTE 7 -- NOTES PAYABLE

     The Company has presented the $3,600,000 note payable due on December 31,
1997 as a current liability in the accompanying December 31, 1996 balance sheet.
See "Management's Discussion and Analysis of Financial Condition and Results of
Operations -- Liquidity and Capital Resources" for discussion regarding the
Company's intent to refinance this amount as part of the Permanent Financing.

NOTE 8 -- SUBSEQUENT EVENTS

     On January 2, 1997, the Company issued 142,857 shares of Series C
Redeemable Convertible Preferred Stock to Genesis for $2,500,000. As of that
issuance, Genesis held 571,428 shares of Series C Redeemable Convertible
Preferred Stock. In addition, on January 31, 1997, the Company and Genesis
entered into a Note Purchase Agreement pursuant to which Genesis agreed to
provide the Company a $5,000,000 credit facility. The Company issued its
Convertible Subordinated 11% Promissory Note to Genesis and on January 31, 1997,
Genesis advanced the sum of $2,800,000 pursuant to the credit facility. The
credit facility matures on January 31, 1999 or the consummation of a $30,000,000
debt and/or equity Permanent Financing (See Management Discussion and Analysis
of Financial Condition and Results of Operations -- Liquidity and Capital
Resources). The $5,000,000 note is convertible at the option of Genesis into a
minimum of 500,000 shares of Convertible Series C Preferred stock. Beginning on
March 31, 1997, the Company may request additional advances under the Note.
Also, on January 31, 1997, the Company issued to Genesis a Warrant to purchase
250,000 shares of Class A Common stock at $14.00 per share.

     On January 13, 1997, the Company repaid to First National Bank of Maryland
$983,017 which represents the retirement of the bridge loan facility.

     On March 4, 1997, the Company completed the merger of Medtrust Medical
Group, Inc. into Doctors Health of Virginia, Inc. ("DHVA"), a wholly-owned
subsidiary of the Company. In connection with the Merger, DHVA became the
successor to Medtrust's non-exclusive independent practice association and
certain Medtrust members entered into exclusive participation agreements with a
Company-owned independent practice association. Pursuant to the merger, members
of Medtrust and certain directors and officers of Medtrust received cash and
shares of the Company's Class B Common Stock.

                                       6

<PAGE>

ITEM 2. MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS
OF OPERATIONS

  OVERVIEW

     Doctors Health System is a managed care and medical management company
which develops and consolidates individual and groups of internists,
pediatricians and family practitioners ("primary care physicians" -- PCPs),
specialist physicians, hospitals and other health care providers into primary
care-driven, comprehensive managed care health delivery networks. PCPs and
specialist physicians are referred to herein as the "Network Physicians." The
Company is focusing on the development of its networks in the Baltimore and
Washington metropolitan area and surrounding regions. As of December 31, 1996,
the Company had approximately 310 Network PCPs in six regional networks
throughout the state of Maryland and one regional network in Northern Virginia.

     The Company provides services to its Network Physicians, who deliver health
care services to patients under various reimbursement mechanisms. The Company's
level of profitability depends on (i) increasing the number of Network
Physicians, (ii) attracting patients to enroll in benefit plans that enter into
Global Capitated Contracts with the Company (principally Medicare
beneficiaries), (iii) securing additional and maintaining Global Capitated
Contracts, with adequate reimbursement rates and (iv) generating earnings
through assisting Network Physicians in managing the delivery of high quality
care at a cost less than the reimbursement received under Global Capitated
Contracts. As of December 31, 1996, the Company has two Global Capitated
Medicare Contracts and one Commercial Contract.

     The Company intends to continue acquiring certain assets of medical
practices and obtaining managed care contracting rights and is currently in
active discussions with a number of primary and specialty care physicians. The
Company intends to begin management of multi-speciality CMGs pursuant to a
medical practice asset acquisition of and merger with a cardiology practice. The
Company also expects to derive revenues and earnings from the participation of
physicians in its Independent Practice Association (IPAs). As of September 30,
1996, 50 Network PCPs were participants in the Company's IPAs. As of December
31, 1996, the Network PCPs participating in the Company's IPAs increased to 186.

  RESULTS OF OPERATIONS

     The Company's operating results are significantly affected by the number of
Network PCPs, the number of Network PCPs participating in Global Capitated
Contracts, the number of executed Global Capitated Contracts, and the number of
patients enrolled in benefit plans under Global Capitated Contracts with the
Company. The following table summarizes the Company's history with respect to
Network PCPs, executed Global Capitated Contracts and patients enrolled in
benefit plans under Global Capitated Contracts with the Company:

<TABLE>
<CAPTION>
                                                                              JUNE 30,    JUNE 30,    SEPTEMBER 30,    DECEMBER 31,
                                                                                1995        1996          1996             1996
                                                                              --------    --------    -------------    ------------
<S> <C>
Number of Network PCPs as of...............................................      24           155           176              310
Number of Network PCPs participating in Global Capitated Contracts as of...      --            45*           45               62
Number of regional networks as of..........................................       1             5             6                7
Number of Global Capitated Contracts as of.................................      --             3             3                3
Number of Global Capitated Patients:
  Commercial...............................................................      --         2,039         2,174            2,272
  Medicare.................................................................      --           491           965            1,283
</TABLE>

*There is a lag between when physicians join networks and when they become
 eligible to participate in Global Capitated Contracts as a result of the
 credentialing process and other internal Company controls.

     The increase in the number of Network Physicians has contributed to the
increase in net revenue growth as well as the increase in operating costs to
support physician growth. In preparation for the acquisition of medical
practices and other physician transactions, the Company had invested in the
personnel and infrastructure necessary to accommodate its anticipated growth,
which resulted in substantial increases in corporate expenses throughout 1996
and 1995.

                                       7

<PAGE>

     The following table shows the percentage of total revenues represented by
various expense and other income items reflected in the Company's Unaudited
Consolidated Statements of Operations. The information that follows should be
read in conjunction with the Company's unaudited consolidated financial
statements and notes thereto included elsewhere herein. As a result of the
Company's rapid growth and the limited period of affiliation with the physician
practices, the Company does not believe that the period-to-period comparisons
and percentage relationships within periods are fully meaningful at this time.

<TABLE>
<CAPTION>
                                                                          THREE MONTHS ENDED               SIX MONTHS ENDED
                                                                     DECEMBER 31,    DECEMBER 31,    DECEMBER 31,    DECEMBER 31,
                                                                         1995            1996            1995            1996
                                                                     ------------    ------------    ------------    ------------
<S> <C>
Net revenue.......................................................       100.0%           54.9%          100.0%           58.4%
Capitation revenue................................................          --            45.1%             --            41.6%
                                                                         -----           -----           -----           -----
Total revenues....................................................       100.0%          100.0%          100.0%          100.0%
Medical services expense..........................................          --            51.8%             --            44.7%
Care center costs.................................................        91.4%           54.8%           89.9%           57.2%
General and administrative........................................        92.9%           64.7%           94.1%           69.7%
Depreciation and amortization.....................................        10.3%            5.9%            9.8%            6.1%
Interest and other income.........................................        (4.4)%          (1.4)%          (7.6)%          (1.6)%
Interest expense..................................................         6.5%            3.2%            6.4%            3.7%
Income tax expense................................................          --              --              --              --
                                                                         -----           -----           -----           -----
Net loss..........................................................       (96.7)%         (79.0)%         (92.6)%         (79.8)%
                                                                         =====           =====           =====           =====
</TABLE>

  THREE MONTHS ENDED DECEMBER 31, 1996 COMPARED TO THE THREE MONTHS ENDED
DECEMBER 31, 1995.

     TOTAL REVENUES. The Company's total revenues increased to $4,925,403 for
the three months ended December 31, 1996 from $915,902 for the three months
ended December 31, 1995. This increase was attributable to the growth in net
revenue to $2,705,841 or 54.9% of total revenue from $915,902 or 100% of total
revenue and the increase in capitation revenue to $2,219,562 ($1,572,229 for
Global Capitated Contracts and $647,333 for Gatekeeper Capitation Contracts) or
45.1% of total revenue from $0 over the prior period. These increases resulted
primarily from the increase in the number of Network Physicians from 36 to 310,
the increase in the number of Network Physicians participating in Global
Capitated Contracts from 0 to 62, the increase in the number of Global Capitated
Contracts from 0 to 3 and the increase in the number of Gatekeeper Capitation
Contracts from 0 to 12.

     MEDICAL SERVICES EXPENSE. Medical services expense was $2,550,395 or 51.8%
of total revenue for the three months ended December 31, 1996 compared to $0 of
total revenue for the three months ended December 31, 1995. This increase
resulted from the increase in the number of Network Physicians participating in
Global Capitated Contracts from 0 to 62, the increase in the number of Global
Capitated Contracts from 0 to 3 and the increase in the number of Gatekeeper
Capitated Contracts from 0 to 12. The Company expects these expenses to increase
as the number of Network Physicians participating in and the number of patients
enrolled in benefit plans under Global Capitated Contracts with the Company
grows.

     CARE CENTER COSTS. Care center costs were $2,696,243 or 54.8% of total
revenue for the three months ended December 31, 1996 compared to $837,452 or
91.4% of total revenue for the three months ended December 31, 1995. This
increase in dollar amount resulted from the increase in the number of Network
Physicians from 36 to 310. While these expenses are expected to increase as the
Company continues adding Network Physicians, the Company expects that these
expenses will continue to decline as a percentage of total revenue assuming
continued growth in revenue.

     GENERAL AND ADMINISTRATIVE EXPENSES. General and administrative expenses
were $3,184,390 or 64.7% of total revenue for the three months ended December
31, 1996 compared to $850,635 or 92.9% of total revenue for the three months
ended December 31, 1995. This increase in dollar amount resulted primarily from
increased compensation expenses from expansion of the Company's corporate
management team, as well as its marketing, acquisitions, network development and
care management departments and additional costs incurred in adding physicians
to the Company's networks and attracting patients who enroll in benefit plans
under Global Capitated Contracts. While these expenses are expected to increase
as the Company adds Network Physicians, the Company expects that these expenses
will continue to decline as a percentage of total revenues assuming continued
growth in revenue.

     DEPRECIATION AND AMORTIZATION EXPENSES. Depreciation and amortization
expenses were $288,693 or 5.9% of total revenue for the three months ended
December 31, 1996 compared to $94,310 or 10.3% of total revenue for the three
months

                                       8

<PAGE>

ended December 31, 1995. The increase in dollar amount resulted primarily from
intangibles acquired in connection with the purchase of certain medical practice
assets from Equity Physicians, as well as fixed asset additions. While these
expenses are expected to increase as the Company continues adding Equity
Physicians to the affiliated CMGs, the Company expects that these expenses will
continue to decline as a percentage of total revenue assuming continued growth
in revenue.

     INTEREST AND OTHER INCOME. Interest and other income was $68,767 or 1.4% of
total revenue for the three months ended December 31, 1996 compared to $39,950
or 4.4% of total revenue for the three months ended December 31, 1995.

     INTEREST EXPENSE. Interest expense was $158,729 or 3.2% of total revenue
for the three months ended December 31, 1996 compared to $59,356 or 6.5% of
total revenue for the three months ended December 31, 1995. The increase in
dollar amount resulted primarily from the increase in the level of borrowings.

     INCOME TAX EXPENSE. In light of the Company's losses and its allowance for
deferred tax assets, for the three months ended December 31, 1996 and 1995, the
Company did not require a provision for income taxes.

     NET LOSS. The Company had a net loss of $3,884,280 for the three months
ended December 31, 1996 compared to $885,901 for the three months ended December
31, 1995.

     LOSS APPLICABLE TO COMMON STOCK. The Company's net loss is increased by
dividends payable to the Redeemable Convertible Preferred Stockholders. The net
loss applicable to common stock was $4,213,041 for the three months ended
December 31, 1996 compared to $999,651 for the three months ended December 31,
1995.

  SIX MONTHS ENDED DECEMBER 31, 1996 COMPARED TO SIX MONTHS ENDED DECEMBER 31,
1995.

     TOTAL REVENUES. The Company's total revenues increased to $8,387,527 for
the six months ended December 31, 1996 from $1,472,969 for the six months ended
December 31, 1995. This increase was attributable to the growth in net revenue
to $4,900,352 or 58.4% of total revenue from $1,472,969 or 100% of total revenue
and the increase in capitation revenue to $3,487,175 ($2,498,842 Global
Capitation and $988,333 from Gatekeeper Capitation Contracts) or 41.6% of total
revenue from $0 over the prior year. These increases resulted primarily from the
increase in the number of Network Physicians from 36 to 310, the increase in the
number of Network Physicians participating in Global Capitated Contracts from 0
to 62, the increase in the number of Global Capitated Contracts from 0 to 3 and
the increase in the number of Gatekeeper Capitation Contracts from 0 to 12.

     MEDICAL SERVICES EXPENSE. Medical services expense was $3,745,896 or 44.7%
of net revenue for the six months ended December 31, 1996 compared to $0 or 0%
of net revenue for the six months ended December 31, 1995. These increases
resulted form the increase in the number of Network Physicians participating in
Global Capitation Contracts from 0 to 62, the increase in the number of Global
Capitated Contracts from 0 to 3 and the increase in the number of Gatekeeper
Capitation Contracts from 0 to 12. The Company expects these expenses to
increase as the number of Network PCPs participating in and the number of
patients enrolled in benefit plans under Global Capitation Contracts with the
Company grows.

     CARE CENTER COSTS. Care center costs were $4,799,762 or 57.2% of total
revenue for the six months ended December 31, 1996 compared to $1,323,703 or
89.9% of total revenue for the six months ended December 31, 1995. The increase
in dollars resulted from the increase in the number of Network Physicians from
36 to 310.

     GENERAL AND ADMINISTRATIVE EXPENSES. General and administrative expenses
were $5,854,470 or 69.7% of total revenue for the six months ended December 31,
1996 compared to $1,386,750 or 94.1% of net revenue for the six months ended
December 31, 1995. The increase in dollars resulted primarily from increased
compensation expenses from development of the Company's corporate management
team, as well as the formation of its marketing, acquisitions, network
development and care management functions and additional organizational costs
from developing physician networks.

     DEPRECIATION AND AMORTIZATION EXPENSES. Depreciation and amortization
expenses were $513,077 or 6.1% of total revenue for the six months ended
December 31, 1996 compared to $144,855 or 9.8% of total revenue for the six
months ended December 31, 1995. The increase in dollars resulted primarily from
intangibles acquired in connection with the purchase of certain medical practice
assets from Equity Physicians, as well as fixed asset additions.

     INTEREST AND OTHER INCOME. Interest and other income was $137,805 or 1.6%
of total revenue for the six months ended December 31, 1996 compared to $111,755
or 7.6% of total revenue for the six months ended December 31, 1995.

     INTEREST EXPENSE. Interest expense was $306,944 or 3.7% of total revenue
for the six months ended December 31, 1996 compared to $94,467 or 6.4% of total
revenue for the six months ended December 31, 1995. The increase in dollars
resulted primarily from the increase in the level of borrowings.

                                       9

<PAGE>

     INCOME TAX EXPENSE. In light of the Company's losses and its allowance for
deferred tax assets, for the six months ended December 31, 1996 and 1995, the
Company did not require a provision for income taxes.

     NET LOSS. The Company had a net loss of $6,694,817 for the six months ended
December 31, 1996 compared to $1,365,051 for the six months ended December 31,
1995.

     LOSS APPLICABLE TO COMMON STOCK. The Company's net loss is increased by
dividends payable to the Redeemable Convertible Preferred Stockholders. The net
loss applicable to common stock was $7,246,602 for the six months ended December
31, 1996 compared to $1,560,051 for the six months ended December 31, 1995.

  LIQUIDITY AND CAPITAL RESOURCES

     As of December 31, 1996, the Company had approximately $2,800,000 in
available cash and negative working capital of $2,870,000 (excluding the
remaining amount available under the Bridge Loan Facility which was repaid on
January 13, 1997). On January 2, 1997, the Company received $2,500,000 in
exchange for 142,857 shares of Redeemable Convertible Series C Preferred Stock.
The negative working capital is a result of the presentation of the $3,600,000
note payable due on December 31, 1997, as a current liability. See the
discussion below regarding the Company's intent to refinance this amount as part
of the Permanent Financing. On January 13, 1997, the Company repaid the Bridge
Loan Facility of $983,017.

     On January 31, 1997, the Company established a $5,000,000 credit facility
(the "Subordinated Debt Facility") with an affiliate of the Series C Preferred
Stockholder, which was guaranteed by the Series C Preferred Stockholder. The
Subordinated Debt Facility will mature on January 31, 1999, unless made part of
the Permanent Financing (as described below). Advances under the Subordinated
Debt Facility will bear interest at a rate of 11% per annum. Such interest shall
be payable at maturity in shares of Series C Preferred Stock at the rate of
$14.00 per share. The Subordinated Debt Facility is subordinated to the
Company's bank line-of-credit and is secured by a second lien on all accounts
receivable and assets. Advances under the Subordinated Debt Facility are
convertible into shares of Series C Preferred Stock at maturity or in
conjunction with the Permanent Financing at a price per share equal to the
lesser of (i) the price which would result in a weighted average price of $14.00
per share for all shares of Series C Preferred stock issued by the Company or
(ii) the price assigned to shares of the Company's securities issued in the
Permanent Financing. In connection with the execution of the Subordinated Debt
Facility, the Company and the Series C Preferred Stockholder amended their
Option Agreement dated September 4, 1996 to reduce the shares issuable pursuant
to the Option from 500,000 shares of Series C Preferred Stock to 250,000 shares
of Series C Preferred Stock, and a reduction in the cash available to the
Company under the Option from $10,000,000 to $5,000,000. The amended Option
Agreement dated January 31, 1997, provides that the Company may require the
Series C Preferred Stockholder to purchase 250,000 shares of Series C Preferred
Stock at a price of $20.00 per share when the Company's Global Capitation
Contracts include at least 20,000 Medicare lives. The Series C Preferred
Stockholder may exercise the option at any time prior to the occurrence of
certain events, including completion of a public offering or Permanent Financing
transaction.

     The Company is seeking a $630,000 letter of credit (LOC) from First
National Bank of Maryland which the Company believes will be issued in March
1997. The LOC is a requirement under one of the Company's Medicare Capitated
Contracts with a health maintenance organization. The Medicare Capitated
Contract requires the Company to provide an LOC, or other similar security, for
a portion of the capitation received by the Company during the previous 60 days.
The LOC will be secured by a $630,000 certificate of deposit funded by the
Company's working capital.

     Until the Company and its Payors attract an adequate number of Capitation
Lives in Global Capitated Contracts, the Company anticipates that it will incur
operating losses and experience negative operating cash flows. The Company
believes that its cash on hand at March 6, 1997, of $3,062,000 and the amounts
remaining available under the Subordinated Debt Facility will be sufficient to
fund the Company's operations through June 30, 1997. However, in the event that
the Company either has not attracted an adequate number of Capitated Lives in
Global Capitated Contracts in order to offset operating expenses, or has not
secured the Permanent Financing described, the Company will not be able to
execute its business strategy and the Company's operating results and financial
condition could be materially and adversely affected.

     Genesis Health Ventures, Inc. ("Genesis"), the Company's Series C Preferred
Stockholder, has agreed to use its best efforts to assist the Company in raising
$30,000,000 in financing (the "Permanent Financing") until April 30, 1997. The
Company and Genesis are evaluating several initiatives for obtaining the
Permanent Financing. The Permanent Financing may be in the form of issuance of
another class of preferred stock, a debt facility or a combination of both. One
such initiative would be to secure a $20,000,000 senior subordinated debt
facility and $10,000,000 in redeemable convertible preferred stock of the
Company. Genesis has indicated to the Company that it desires to participate in
any debt financing

                                       10

<PAGE>

portion of a Permanent Financing. In connection with the $20,000,000 senior
subordinated debt facility, the Company anticipates that it will issue
detachable warrants with a nominal exercise price. The anticipated proceeds from
the Permanent Financing will be used to repay the Subordinated Debt Facility,
repay a bank line of credit, fund working capital needs, acquire certain assets
of physician practices and, subject to approval of the Series A Stockholder and
certain other conditions, redeem the Series B Preferred Stock at par plus
accrued dividends. All equity components must be junior with respect to
dividends, liquidation and redemption to all existing Preferred Stockholders.
The financing sources will be granted Board representation and Genesis will
have the option of designating an additional Board and Executive Committee
member. In exchange for such assistance, the Company (i) agreed until April 30,
1997, to work exclusively with and through Genesis in seeking additional
financing sources and (ii) granted the Series C Preferred Stockholder a
warrant to purchase 250,000 shares of Class A common stock at an exercise
price of $14.00 per share. Upon consummation of the Permanent Financing, the
remaining right and/or commitment of the Series C Preferred Stockholder's
existing options to purchase 250,000 shares of Series C Preferred Stock at a
price of $20.00 per share when the Company's Global Capitated Contracts include
at least 20,000 Medicare lives shall terminate.

     The inability of the Company to obtain such funding, either in whole or in
part, would impair the Company's ability to make intended capital expenditures
and to execute its planned strategy and therefore could have a material adverse
effect on the Company's results of operations and financial condition.

                      FORWARD-LOOKING STATEMENT REGARDING
                            FUTURE OPERATING RESULTS

     This Quarterly Report on Form 10-Q contains statements which, to the extent
they are not recitations of historical fact, may constitute forward-looking
statements regarding future operating results and financial condition. All
forward-looking statements involve risks and uncertainties. Although the Company
believes that its expectations are based upon reasonable assumptions within the
bounds of its knowledge of its business and operations, there can be no
assurance that actual results will not materially differ from its expectations.

     The future operating results and financial condition of the Company are
dependent upon the Company's ability to market its services profitably,
successfully increase market share and manage expense growth relative to revenue
growth. In addition, the future operating results and financial condition of the
Company may also be affected by several factors, including (i) the Company's
growth strategy and its ability to raise sufficient capital to support growth,
(ii) government regulation of the health care industry; (iii) integration risks,
(iv) dependence on managed care contracts and dependence on enrollment patients
in managed care contracts with HMOs, (v) health care cost-containment decisions
of Payors; (vi) controlling and estimating health care costs; and (vii)
competition for opportunities to expand the Company's network of physicians and
health care providers. Changes in one or more of these factors could have a
material adverse effect on the future operating results and financial condition
of the Company.

                                    PART II
                               OTHER INFORMATION

ITEM 4. SUBMISSION OF MATTERS TO A VOTE OF SECURITY HOLDERS

     By unanimous consent in lieu of meeting dated January 29, 1997, the
following matters were submitted to a vote of the Registrant's stockholders:

     1. Adoption of Articles of Amendment and Restatement and Bylaws of the
Registrant to (i) increase the size of the Board of Directors from 18 to 19
members to provide the Series C Preferred Stockholders an additional seat on the
Board; (ii) increase the size of the Executive Committee of the Board from seven
to eight members to provide the Series C Preferred Stockholder an additional
seat on the Executive Committee; (iii) to provide that a majority of the
Executive Committee members constitutes a quorum; and (iv) to increase the
number of authorized shares of Series C Preferred Stock from 1,071,428 shares to
1,500,000 shares.

                                       11

<PAGE>


VOTES FOR                             VOTES AGAINST        ABSTENTIONS
Class A and Class B Common Stock
  4,403,000                                0                    0
Series B Preferred Stock
  355,556                                  0                    0
Series C Preferred Stock
  571,428                                  0                    0


ITEM 6. EXHIBITS AND REPORTS ON FORM 8-K

     (a) Exhibits

     (10.1) Note Purchase Agreement dated January 31, 1997 among Doctors Health
System, Inc., Genesis Health Ventures, Inc. and Genesis Holdings.

     (10.2) Convertible Subordinated 11% Note dated January 31, 1997 and issued
by Doctors Health System.

     (10.3) Amended and Restated Option Agreement by and between Doctors Health
System, Inc. and Genesis Health Ventures, Inc., dated January 31, 1997.

     (10.4) Articles of Amendment and Restatement dated January 31, 1997.

     (10.5) Letter Agreement dated February 1, 1997 for Scott Rifkin, M.D. to
Doctors Health System, Inc.

     (b) Reports on Form 8K

     None

                                       12

<PAGE>

                                   SIGNATURES

     Pursuant to the requirements of the Securities Exchange Act of 1934, the
Registrant caused this report to be signed on its behalf by the undersigned
thereunto duly authorized.


                                         DOCTORS HEALTH SYSTEM, INC.


                                         By: /s/ John R. Dwyer
                                             _______________________
                                             John R. Dwyer
                                             Chief Financial Officer


                                       13






                                                                    EXHIBIT 10.1


                                                                  Execution Copy



                            NOTE PURCHASE AGREEMENT

                                     among


                          DOCTORS HEALTH SYSTEM, INC.,

                             GENESIS HOLDINGS, INC.

                                      and

                         GENESIS HEALTH VENTURES, INC.




                          dated as of January 31, 1997


<PAGE>



                            NOTE PURCHASE AGREEMENT


                  THIS NOTE PURCHASE AGREEMENT is entered into as of January 31,
1997 among Doctors Health System,  Inc., a Maryland corporation (the "Company"),
Genesis Holdings,  Inc., a Delaware  corporation (the  "Investor"),  and Genesis
Health Ventures, Inc., a Pennsylvania corporation ("GHV").


                  WHEREAS,  the Company and GHV  entered  into a Stock  Purchase
Agreement  dated as of  September  4,  1996  (the  "Stock  Purchase  Agreement")
pursuant  to which  GHV  purchased  571,428  shares  of the  Company's  Series C
Preferred Stock (the "Series C Preferred");


                  WHEREAS, the Investor is a wholly-owned subsidiary of GHV; and


                  WHEREAS, the Company desires to issue to the Investor, and the
Investor  desires to subscribe for and acquire from the Company,  a convertible,
subordinated note of the Company, upon the terms and conditions  hereinafter set
forth.

                  NOW,  THEREFORE,  in consideration of the foregoing and of the
mutual covenants and agreements hereinafter set forth, the parties hereto hereby
agree as follows:


1.        DEFINITIONS

                  For  all  purposes  of  this   Purchase   Agreement,   certain
capitalized  terms  specified  in Exhibit A shall have the meanings set forth in
that Exhibit A, except as otherwise expressly provided.


2.        SALE AND PURCHASE OF NOTE


         2.1.      Sale and Purchase of Note

                  On the basis of the representations, warranties and agreements
contained herein,  and subject to the terms and conditions  hereof,  the Company
agrees to issue to the  Investor,  and the Investor  agrees to purchase from the
Company, a convertible subordinated note of the Company due on the Maturity Date
in the maximum principal amount of $5,000,000 and in the form attached hereto as
Exhibit B (the "Note") for an aggregate  purchase  price of up to

<PAGE>


$5,000.000  in  cash  paid  in the form of advances pursuant to Section 2.2. The
terms of the Note are hereby incorporated herein by reference.


         2.2.      Purchase Price; Advances

                  Subject to the terms and conditions of this Purchase Agreement
and provided no Default has occurred and is  continuing,  the Investor shall pay
the  purchase  price  for the  Note to the  Company  in the  form of one or more
advances ("Advances").

                  2.2.1.  Initial Advance.  Subject to the limitations set forth
below, the Investor shall make an Advance to the Company (the "Initial Advance")
in an amount not greater than the Company's projected cash needs for the 60 days
following the Closing as set forth in an Advance Request (in  substantially  the
form attached hereto as Exhibit C) submitted by the Company to, and approved by,
the  Investor.  The  Initial  Advance  shall be payable  to the  Company by wire
transfer of immediately available funds at the Closing.

                  2.2.2.  Future Advances.  Subject to the limitations set forth
below and  commencing  after  April 1, 1997,  the  Investor  shall make  monthly
Advances to the  Company  ("Future  Advances")  as  requested  by the Company in
Advance Requests,  provided,  that a Future Advance may not exceed the Company's
projected cash needs for the 30 days following submission of the Advance Request
and  such  Advance  Request  is  approved  by the  Investor.  Provided  that all
conditions to the making of a Future Advance as set forth in Section 9 have been
satisfied,  Future  Advances shall be payable to the Company by wire transfer of
immediately  available funds no later than two Business Days following  delivery
of the Advance Request to the Investor.

                  2.2.3.  Maximum Amount of Any Advance. No Advance shall exceed
the lesser of (a) $5,000,000,  (b) $5,000,000  minus the aggregate amount of all
prior Advances plus the aggregate  amount of all  repayments and  prepayments of
principal  pursuant  to  Section  2.4 or (b) the  projected  cash  needs  of the
Company,  as approved by the Investor,  for the following 60 days in the case of
the Initial Advance and 30 days in the case of Future Advances.


         2.3.      Interest

                  The  aggregate  unpaid  principal  amount of each Advance from
time to time  outstanding  shall bear  interest,  from the date of such  Advance
until paid in full, at an annual rate of interest  equal to 11%.  Payment of all
accrued interest shall be made by the Company on the Maturity Date by issuing to
the Investor the number of shares of Series C Preferred  derived by dividing (x)
the aggregate dollar

                                       2

<PAGE>


amount  of  all such accrued  interest by (y) 14. The issue price of such shares
of Series C Preferred shall be $14 per share.


         2.4.      Repayments and Prepayments

                  2.4.1.  Maturity Date. The entire outstanding principal amount
of all Advances (the "Outstanding Principal Amount") shall become absolutely due
and  payable by the  Company to the  Investor  upon the  earlier to occur of (a)
January  31,  1999  or (b)  the  closing  date of a  financing  (the  "Permanent
Financing") of up to $25,000,000 in additional debt and/or equity by the Company
(the  "Maturity  Date"),  unless  Investor  exercises  its right to convert  the
Outstanding  Principal Amount into Series C Preferred or the Permanent Financing
in accordance with the terms hereof.

                  2.4.2. Prepayments. The Company shall have the right to prepay
the Outstanding  Principal Amount in full or in part at any time without premium
or penalty,  provided,  however  that the Company  shall  notify the Investor at
least 30 days prior to any  prepayment and the Investor shall have 20 days after
such notice to elect to convert the portion of the Outstanding  Principal Amount
that the Company  proposes to prepay into shares of Series C Preferred  Stock at
the Conversion Price provided for in Section 2.5.


         2.5.      Conversion

                  2.5.1.  At Maturity  Date. At the Maturity  Date, the Investor
may elect to (A) convert all or a portion of the  Outstanding  Principal  Amount
into the  number of shares of Series C  Preferred  derived by  dividing  (x) the
Outstanding Principal Amount (or the portion thereof to be converted) by (y) the
Conversion Price or (B) incorporate the Outstanding  Principal Amount as debt or
equity in the Permanent Financing.

                  2.5.2.  Upon  Prepayment.  As provided in Section 2.4.2 above,
the  Investor  shall have the right to convert  any  portion of the  Outstanding
Principal  Amount that the Company  proposes to prepay into the number of shares
of Series C  Preferred  derived by dividing  (x) the portion of the  Outstanding
Principal Amount to be prepaid by (y) the Conversion Price.

                  2.5.3.  Mandatory Conversion.  In the event that, prior to the
Maturity Date,  the Company closes the loan facility  committed by the holder of
the Company's Series A Preferred Stock in an amount of at least $10,000,000, the
Company shall have the right to require the Investor to convert the  Outstanding
Principal  Amount  into the  number of shares of Series C  Preferred  derived by
dividing (x) the Outstanding  Principal Amount by (y) the Conversion Price. Such

                                       3

<PAGE>


mandatory conversion right shall be exercisable by the Company by written notice
to the  Investor  no  later  than 15 days  prior  to the  closing  of such  loan
facility.

                  2.5.4.  Conversion Price. For purposes hereof,  the Conversion
Price shall be the lesser of (a) the purchase  price per share for each issuance
of Series C Preferred  upon any  conversion  pursuant to this  Section 2.5 which
results in a weighted  average  price of all  issued and  outstanding  shares of
Series C Preferred,  including the shares issued in such  conversion,  of $14.00
per share or (b) the purchase  price per share of Series C Preferred used in the
Permanent  Financing (if the Permanent  Financing  involves issuance of Series C
Preferred).

3.        REPRESENTATIONS AND WARRANTIES OF THE COMPANY

                  Except as  specifically  set forth in the Disclosure  Schedule
(with no  disclosure  to be deemed to apply with  respect to any Section of this
Purchase Agreement to which it does not expressly refer), the Company represents
and warrants (which  representations  and warranties  shall be deemed to include
the disclosure with respect thereto so specified in the Disclosure  Schedule) to
the Investor as follows:


         3.1.      Organization and Standing

                  The Company is a corporation duly organized,  validly existing
and in good standing  under the laws of the State of Maryland,  and has the full
and  unrestricted  corporate  power and authority to own,  operate and lease its
Assets, to carry on its business as currently conducted,  to execute and deliver
this Purchase Agreement and to carry out the transactions  contemplated  hereby.
There is no state,  country or  territory  wherein the absence of  licensing  or
qualification as a foreign corporation would have a material adverse effect upon
the business of the Company as currently conducted.


         3.2.      Subsidiaries

                  The Company has no  Subsidiaries  and no equity  investment or
other  interest  in,  nor has  the  Company  made  advances  or  loans  to,  any
corporation,  association, partnership, joint venture or other entity, except as
set forth in the Disclosure  Schedule.  Section 3.2 of the  Disclosure  Schedule
sets forth (a) the authorized capital of each direct and indirect  Subsidiary of
the Company and the  percentage of the  outstanding  capital of each  Subsidiary
directly or  indirectly  owned by the Company,  and (b) the nature and amount of
any such equity  investment  or other  equity  interest.  All equity  capital of
Subsidiaries directly or indirectly held by the Company has been duly authorized
and validly issued and is outstanding,  fully paid and nonassessable.  Except as
set forth in the  Disclosure  Schedule,  the  Company  directly,  or  indirectly
through wholly owned Subsidiaries,

                                       4

<PAGE>

owns all such equity capital of the direct  or indirect  Subsidiaries  free  and
clear of all  Encumbrances.  Each Subsidiary is duly organized, validly existing
and in good standing (or its local equivalent) under the laws  of  its  state or
jurisdiction  of  organization  (as listed in the Disclosure  Schedule), and has
the full and  unrestricted  corporate  power and authority  to own,  operate and
lease  its  Assets  and  to  carry  on its business as currently conducted. Each
Subsidiary is registered to conduct business and is  in  good  standing  in  the
states,  countries and territories listed in the Disclosure Schedule.  There  is
no state,  country  or  territory  wherein  the  absence  of registration  as  a
foreign  corporation would have a material adverse effect upon the  business  of
the Subsidiaries as currently conducted.


         3.3.      Articles of Incorporation and Bylaws

                  The  Company  has  delivered  to the  Investor  (i) a true and
complete  copy of the Restated  Articles and the bylaws,  as currently in effect
and certified by the secretary of the Company, and (ii) a true and complete copy
of the organizational documents of each Subsidiary, as currently in effect. Such
copies are attached as exhibits to, and part of,  Section 3.3 of the  Disclosure
Schedule.


         3.4.      Capitalization

                  Upon the  filing  of the  Restated  Articles,  the  authorized
capital stock of the Company and the outstanding  shares of capital stock of the
Company  as of the  date  hereof  will be as set  forth  in  Section  3.4 of the
Disclosure Schedule. All of such outstanding shares have been validly issued and
are fully paid and  nonassessable.  No shares of capital stock of the Company or
any  Subsidiary  have been  reserved  for any  purpose,  other than  issuance of
capital stock in amounts set forth in Section 3.4 of the Disclosure Schedule (i)
pursuant to the Company's  Omnibus Stock Option Plan , (ii) upon the  conversion
of Series A  Preferred  Stock and the Series B Preferred  Stock,  (iii) upon the
exercise  of the  Common  Stock  Warrants  (as  defined  in  Section  3.4 of the
Disclosure  Schedule) and (iv) pursuant to the Option  Agreement.  Except as set
forth in  Section  3.4 of the  Disclosure  Schedule,  there  are no  outstanding
securities convertible into or exchangeable for the capital stock of the Company
or any of the Subsidiaries  and no outstanding  options,  rights  (preemptive or
otherwise), or warrants to purchase or to subscribe for any shares of such stock
or other  securities  of the Company or any of the  Subsidiaries.  Except as set
forth in  Section  3.4 of the  Disclosure  Schedule,  there  are no  outstanding
Agreements affecting or relating to the voting, issuance, purchase,  redemption,
repurchase,  transfer or  registration  for sale under the Securities Act of the
Company's common stock,  any other securities of the Company,  or any securities
of any Subsidiary.

                                       5

<PAGE>


         3.5.      Directors, Officers and Employees

                  Section  3.5 of the  Disclosure  Schedule  lists  all  current
directors  and  officers  of  the  Company  and  all  managers,   employees  and
consultants of the Company who, individually,  have received or are scheduled to
receive  compensation  from the Company for the year ending December 31, 1996 in
excess of  $100,000,  showing each such  person's  name,  positions,  and annual
remuneration and material bonuses for the current fiscal year.

         3.6.      Financial Statements

                  (a) The Company has prepared and delivered to the Investor and
there are included as exhibits that are part of Section 3.6(a) of the Disclosure
Schedule,  the Consolidated  balance sheets of the Company, the Subsidiaries and
the Medical Groups as of the end of the fiscal year ended June 30, 1996, and the
Consolidated statements of income, stockholders' equity and changes in financial
position for such year, accompanied by the unqualified opinion of Grant Thornton
L.L.P.  The Company also has prepared and delivered to the  Investor,  and there
are  included  as  exhibits  that are part of Section  3.6(a) of the  Disclosure
Schedule, an internal financial reporting package,  which includes the unaudited
Consolidated  balance  sheet of the Company as of  November  30,  1996,  and the
unaudited Consolidated statements of income, stockholders' equity and changes in
financial  position  for the six months  ended  November  30,  1996.  All of the
financial statements, including, without limitation, the notes thereto, referred
to in this  Section  3.6 or  delivered  to the  Investor  after the date  hereof
pursuant to this Purchase  Agreement:  (a) are in accordance  with the books and
records of the Company,  the  Subsidiaries  and the Medical Groups,  (b) present
fairly the Consolidated  financial position of the Company, the Subsidiaries and
the Medical Groups as of the respective  dates and the results of operations and
changes in financial position for the respective periods indicated (subject,  in
the case of the November 30, 1996  statements,  to the absence of footnotes  and
normal  adjustments),  and (c) have been prepared in accordance  with  generally
accepted accounting  principles  (subject,  in the case of the November 30, 1996
statements,  to the absence of footnotes and to normal adjustments) applied on a
basis consistent with prior accounting periods.

                  (b) The Company has prepared and delivered to the Investor and
has  included as an exhibit to Section  3.6(b) of the  Disclosure  Schedule  the
Company's operating plan for the period ending December 31, 1997 (the "Operating
Plan"), which (i) has been prepared in good faith on a basis consistent with the
historical Consolidated financial statements furnished pursuant to this Purchase
Agreement  and,  to  the  Company's  knowledge,   consistent  with  the  payment
arrangements  contemplated in the Company's  agreements with health  maintenance
organizations  and other  payors  which have

                                       6

<PAGE>


been entered into prior to the date hereof  and (ii)  represents  the  Company's
good faith best  judgment as to the expected financial  condition and results of
operations of the Company at and for the period ending December 31, 1997. To the
Company's knowledge,  the attainment by the  Company  of the results  forecasted
in  the  Operating  Plan  will  not  violate  any  Laws  currently in effect and
applicable  to  the  Company,  the  Subsidiaries,  the  Medical  Groups or their
operations.  The  results  forecasted in  the  Operating  Plan are  management's
estimates  and do not  constitute  a warranty  as to the future  performance  of
the Company.


         3.7.      No Liabilities

                  Except as reflected  in the  November  30, 1996 balance  sheet
attached  as part of Section 3.7 of the  Disclosure  Schedule or incurred in the
Ordinary  Course of  Business  (in  amounts not  material  to the  Company,  its
Subsidiaries and the Medical Groups, taken as a whole), as of November 30, 1996,
there were no liabilities (whether contingent or absolute, matured or unmatured,
known or unknown) of the Company, any Subsidiary or any Medical Group that would
be required by GAAP to be disclosed therein.  Except as described in Section 3.7
of the  Disclosure  Schedule,  since  November  30,  1996,  the  Company has not
incurred any liabilities (whether contingent or absolute,  matured or unmatured,
known or unknown)  other than in the Ordinary  Course of Business and in amounts
that are not material to the Company,  its  Subsidiaries and the Medical Groups,
taken as a whole.


         3.8.      Accounts Receivable

                  The accounts  receivable of the Company,  the Subsidiaries and
the Medical  Groups shown on the balance  sheets  delivered  pursuant to Section
3.6, or  thereafter  acquired  by any of them,  have been  collected  or, to the
knowledge of the Company,  are  collectible in amounts not less than the amounts
thereof carried on the books of the Company,  the  Subsidiaries  and the Medical
Groups,  except to the extent of the  allowance for doubtful  accounts  shown on
such balance sheets and the additional  write-off of certain accounts receivable
set forth on the Disclosure Schedule. The accounts receivable of the Company and
all  documents  relating to such accounts  receivable  shall be kept only at the
Company's offices located at 10451 Mill Run road, Owings Mills,  Maryland 21117,
or at 8019 Corporate Drive, Suite 2, White Marsh, Maryland 21236.


         3.9.      Taxes

                  (a) All Company Tax Returns due on or before the date  hereof,
or which  become due after the date  hereof and on or before the  Closing  Date,
have been,  or will be, duly filed.  No penalties  or other  charges are or will
become due

                                       7

<PAGE>


with respect to any of the Company Tax Returns so filed as  the  result  of  the
late filing thereof.  All of the Company Tax Returns so filed are  (or,  in  the
case  of  returns  becoming  due  after  the  date  hereof  and on or before the
Closing  Date,  will be) true and complete in all  respects.  The  Company,  its
Subsidiaries or the Medical Groups: (i) have paid all Taxes due or claimed to be
due by any taxing  authority in  connection  with any of the Company Tax Returns
(without  regard to whether  or not such Taxes are shown as due on such  Company
Tax Returns);  or (ii) have established (or, in the case of amounts becoming due
after the date hereof,  prior to the Closing Date will have paid or established)
in  financial  statements  provided  to the  Investor  pursuant  to Section  3.6
adequate reserves (in conformity with generally accepted  accounting  principles
consistently  applied)  for the  payment of such  Taxes.  The  amounts set up as
reserves  for Taxes on the  Consolidated  financial  statements  of the  Company
delivered  pursuant to Section 3.6 are  sufficient for the payment of all unpaid
Taxes, whether or not such Taxes are disputed or are yet due and payable, for or
with  respect to the period,  and for which the Company may be liable in its own
right (including,  without  limitation,  by reason of being a member of the same
affiliated  group) or as a  transferee  of the Assets of, or  successor  to, any
corporation, person, association, partnership, joint venture or other entity.

                  (b) Neither the Company, any Subsidiary nor any Medical Group,
either in its own right  (including,  without  limitation,  by reason of being a
member of the same affiliated  group) or as a transferee,  has or on the Closing
Date will  have any  liability  for Taxes  payable  for or with  respect  to any
periods  prior to and  including  the  Closing  Date in  excess  of the  amounts
actually paid prior to the Closing Date or reserved for in financial  statements
delivered to the Investor pursuant to Section 3.6.

                  (c) All Company Tax Returns  have been filed with the relevant
taxing  authorities,  and all  deficiencies  related to such Company Tax Returns
proposed as a result of such examinations  have been paid or settled.  Except as
set forth in  Section  3.9(c) of the  Disclosure  Schedule,  there is no action,
suit, proceeding,  audit, investigation or claim pending or, to the knowledge of
the Company,  threatened in respect of any Taxes for which the Company is or may
become liable, nor has any deficiency or claim for any such Taxes been proposed,
asserted or, to the knowledge of the Company,  its  Subsidiaries  or the Medical
Groups,  threatened.  Except as set forth in  Section  3.9(c) of the  Disclosure
Schedule (i) no agreement,  waiver or consent providing for an extension of time
with respect to the assessment or collection of any Taxes against the Company is
outstanding,  and (ii) no power of attorney  granted by the Company with respect
to any tax matters is currently in force.

                  (d) The Company has delivered or otherwise  made  available to
the Investor true and complete copies of all Company Tax Returns and all written

                                       8

<PAGE>


communications  relating to any such Company Tax Returns or to any deficiency or
claim proposed and/or asserted,  irrespective of the outcome of such matter, but
only to the extent  such items  relate to tax years (i) which are  subject to an
audit,  investigation,  examination or other proceeding, or (ii) with respect to
which the statute of limitations has not expired.

                  (e) Section 3.9(e) of the  Disclosure  Schedule sets forth (i)
all federal tax elections  previously filed and currently in effect with respect
to the Company or any of the  Subsidiaries or the Medical  Groups,  and (ii) all
elections and consents  previously filed and currently in effect for purposes of
state or local Taxes, in each case that  reasonably  could be expected to affect
or be binding upon the Company or any of the  Subsidiaries or the Medical Groups
or their respective  Assets or operations  after the Closing.  Section 3.9(e) of
the Disclosure  Schedule sets forth all federal Forms 3115 filed with respect to
the Company or any of the Subsidiaries.

                  (f) Neither the  Company  nor any of the  Subsidiaries  or the
Medical Groups is a party to an Agreement relating to the sharing, allocation or
payment of, or indemnity for, Taxes (other than an Agreement the only parties to
which are the Company, the Subsidiaries and/or the Medical Groups).


         3.10.     Conduct of Business; Absence of Material Adverse Change

                  Other  than as set  forth in  Section  3.10 of the  Disclosure
Schedule,  since November 30, 1996,  there has been no material  adverse change,
and no  change  except in the  Ordinary  Course of  Business,  in the  business,
operations, condition (financial or otherwise), Assets, liabilities or prospects
of the Company.  Except as set forth in Section 3.10 of the Disclosure Schedule,
since November 30, 1996,  the Company has conducted its business  diligently and
substantially in the manner heretofore conducted and only in the Ordinary Course
of Business,  and the Company has not,  except as  contemplated by this Purchase
Agreement,  (a) incurred loss of, or significant  injury to, any Material Assets
of the  Company  as  the  result  of  any  fire,  explosion,  flood,  windstorm,
earthquake,  labor trouble,  riot, accident, act of God or public enemy or armed
forces,  or  other  casualty;  (b)  issued  any  capital  stock,  bonds or other
corporate securities or debt instruments, granted any options, warrants or other
rights calling for the issuance thereof, or borrowed any funds; (c) incurred, or
become subject to, any obligation or liability (absolute or contingent,  matured
or unmatured,  known or unknown),  except  current  liabilities  incurred in the
Ordinary Course of Business; (d) discharged or satisfied any Encumbrance or paid
any obligation or liability (absolute or contingent, matured or unmatured, known
or unknown) other than current liabilities shown in the balance sheets delivered
pursuant to Section 3.6, and current  liabilities  incurred  since  November 30,
1996 in the Ordinary Course of Business; (e) declared or made payment of, or set
aside for payment,  any dividends

                                      9

<PAGE>


or  distributions  of  any  Assets, or purchased, redeemed or otherwise acquired
any  of its  capital  stock,  any  securities convertible into capital stock, or
any other securities; (f) mortgaged,  pledged or subjected  to  any  Encumbrance
any of its  Material Assets;  (g)  sold,  exchanged,  transferred  or  otherwise
disposed of any of its Material Assets, or canceled any debts or claims,  except
in each case in the Ordinary  Course of  Business;  (h) written  down the  value
of any Material  Assets or written off as  uncollectible any  notes  or accounts
receivable,  except  write-downs  and  write-offs  in  the  Ordinary  Course  of
Business,  none of which,  individually or in the aggregate, are material to the
Company, the Subsidiaries and the Medical Groups, taken as a whole;  (i) entered
into  any  transactions  other  than  in  the  Ordinary Course of Business;  (j)
increased the rate of compensation payable,  or to  become  payable,  by  it  to
any  of  its  officers,  employees, agents or independent contractors  over  the
rate  being  paid  to  them on November  30,  1996,  other than in the  Ordinary
Course of Business;  (k) made or permitted any amendment or  termination  of any
material  Agreement  to  which it is a party  or  which  it  owns;  (l)  through
negotiation  or otherwise  made any  commitment or incurred any liability to any
labor  organization;  (m) made any  accrual  or  arrangement  for or  payment of
bonuses  or  special  compensation  of any  kind  to any  director,  officer  or
employee,  other  than in the  Ordinary  Course of  Business;  (n)  directly  or
indirectly  paid any severance or termination  pay to any officer or employee in
excess of two months'  salary;  (o) made capital  expenditures,  or entered into
commitments therefor, aggregating more than $100,000; (p) made any change in any
method of accounting or accounting practice; (q) entered into any transaction of
the type  described in Section  3.22;  or (r) made an Agreement to do any of the
foregoing.


         3.11.     Title to Property and Assets

                  Except  as  set  forth  in  Section  3.11  of  the  Disclosure
Schedule, the Company and the Subsidiaries have good, valid and marketable title
to all Assets  respectively  owned by them,  free and clear of all  Encumbrances
other than those referred to in the balance sheets delivered pursuant to Section
3.6 (or the notes thereto). The Company and the Subsidiaries do not own any real
estate,  and the  Company  is not now and has never been a "United  States  real
property  holding  corporation"  as defined in  ss.897(c)(2) of the Code and ss.
1.897-2(b) of the  regulations  promulgated  thereunder.  All material  items of
personal  property  of the  Company and the  Subsidiaries  is in good  operating
condition  and repair and is suitable  and adequate for the uses for which it is
intended or is being used.


         3.12.     Insurance

                  Other  than as set  forth in  Section  3.12 of the  Disclosure
Schedule,  the Company has insurance  coverage under policies  maintained by the
Company  (including  stop  loss  and  reinsurance  policies)  that  (a) are with
insurance

                                       10

<PAGE>


companies  reasonably  believed  by  the  Company  to  be  financially sound and
reputable; (b) are in full force and effect; (c) are sufficient  for  compliance
by the Company and by each Subsidiary and Medical Group with all requirements of
Law and of all Agreements to which the  Company,  any  Subsidiary or any Medical
Group is a party; (d) are valid and outstanding policies enforceable against the
insurer; and (e) insure  against  risks  of the kind customarily insured against
and in amounts customarily  carried  by  companies  similarly  situated  and  by
companies engaged in similar businesses and owning similar properties.


         3.13.     Intellectual Property

                  (a)  Section  3.13(a)  of the  Disclosure  Schedule  lists all
trademarks,  trademark  applications and registrations,  registered  copyrights,
patents and patent  applications  owned or licensed by or registered in the name
of the Company, any Subsidiary or any Medical Group or used or to be used by the
Company,  any  Subsidiary  or any Medical  Group in its  business  as  presently
conducted or contemplated, and all other items of Intellectual Property that are
material to the business or  operations  of the Company,  any  Subsidiary or any
Medical  Group.   Section  3.13(a)  of  the  Disclosure   Schedule  lists  those
trademarks,  trademark  applications and registrations,  registered  copyrights,
patents and patent  applications which have been duly registered in, filed in or
issued by the United  States  Patent and  Trademark  Office,  the United  States
Register of Copyrights,  or the corresponding  offices of other jurisdictions as
identified in Section 3.13(a) of the Disclosure Schedule, and have been properly
maintained and renewed in accordance  with all applicable  provisions of law and
administrative regulations in the United States and each such jurisdiction.

                  (b) All licenses or other Agreements  material to the business
of the Company, the Subsidiaries and the Medical Groups, taken as a whole, under
which the Company,  any  Subsidiary  or any Medical  Group is granted  rights in
Intellectual Property are listed on the Disclosure Schedule. Except as set forth
in Section  3.13(b)  of the  Disclosure  Schedule,  all such  licenses  or other
Agreements  are in full force and effect,  there is no  material  default by any
party  thereto.  To the  knowledge  of the  Company,  the  licensors  under such
licenses and other  Agreements have and had all requisite power and authority to
grant the rights purported to be conferred thereby.


         3.14.     Debt Instruments

                  Section 3.14 of the  Disclosure  Schedule lists all mortgages,
indentures,  notes,  guarantees and other Agreements for or relating to borrowed
money (including,  without limitation, capital leases) to which the Company, any
Subsidiary  or any  Medical  Group is a party or which have been  assumed by the

                                       11

<PAGE>

Company,  any  Subsidiary  or any  Medical  Group or to which any  Assets of the
Company,  any  Subsidiary  or any Medical  Group are subject.  The Company,  the
Subsidiaries and the Medical Groups have performed all the obligations  required
to be  performed  by any of them to date and are not in default  in any  respect
under any of the foregoing,  and there has not occurred any event which (whether
with or without  notice,  lapse of time or the  happening or  occurrence  of any
other event) would constitute such a default.


         3.15.     Leases

                  Section 3.15 of the  Disclosure  Schedule lists all leases and
other Agreements under which the Company, any Subsidiary or any Medical Group is
lessee or lessor of any  Material  Asset,  or holds,  manages  or  operates  any
Material Asset owned by any third party, or under which any Material Asset owned
by the  Company or by any  Subsidiary  or  Medical  Group is held,  operated  or
managed by a third party.  The Company,  the  Subsidiaries and the Medical Group
are the owners and holders of all the leasehold  estates purported to be granted
by the Documents  described in Section 3.15 of the Disclosure  Schedule to them.
Each such lease and other  Agreement is in full force and effect and constitutes
a legal,  valid and binding obligation of, and is legally  enforceable  against,
the respective  parties  thereto and grants the leasehold  estate it purports to
grant free and clear of all Encumbrances.  All necessary  governmental approvals
with respect thereto have been obtained,  all necessary filings or registrations
therefor have been made, and there have been no threatened cancellations thereof
and are no outstanding  disputes  thereunder.  The Company, the Subsidiaries and
the Medical  Groups have in all  respects  performed  all  material  obligations
thereunder  required  to be  performed  by any of them to  date.  No party is in
default in any respect  under any of the  foregoing,  and there has not occurred
any event which (whether with or without notice,  lapse of time or the happening
or  occurrence  of any other  event)  would  constitute  such a default.  To the
knowledge of the Company,  all of the Assets  subject to such leases are in good
operating condition and repair.


         3.16.     Other Agreements

                  (a)  Section  3.16(a)  of the  Disclosure  Schedule  lists all
material Agreements to which the Company, any Subsidiary or any Medical Group is
a party or by which the Company, any Subsidiary or any Medical Group is bound at
the date  hereof.  True and  correct  copies of such  Agreements  have been made
available to the Investor.  Each such  Agreement is in full force and effect and
constitutes a legal, valid and binding obligation of, and is legally enforceable
against,  the respective parties thereto. All necessary  governmental  approvals
with respect thereto have been obtained,  all necessary filings or registrations
therefor have been made, and there have been no threatened cancellations thereof

                                       12

<PAGE>


and are no outstanding  disputes  thereunder.  The Company, the Subsidiaries and
the Medical  Groups have in all  respects  performed  all  material  obligations
thereunder  required  to be  performed  by any of them to  date.  No party is in
default in any respect under any of the Agreements  described in Section 3.16(a)
of the Disclosure Schedule,  and there has not occurred any event which (whether
with or without  notice,  lapse of time or the  happening or  occurrence  of any
other event) would constitute such a default.

                  (b) Except as specified in Section  3.16(b) of the  Disclosure
Schedule  (and  without  limiting  the  foregoing),  neither the Company nor any
Subsidiary  or Medical  Group is a party to any  written (i)  Agreement  for the
employment  of any  officer,  employee,  consultant  or  independent  contractor
involving  payments of more than  $100,000  over its  remaining  term other than
officers, employees,  consultants or contractors set forth in Section 3.5 of the
Disclosure  Schedule;  (ii)  Agreement  with  any  labor  organization  or other
collective  bargaining unit except as may be imposed by law; (iii) Agreement for
the future purchase of materials,  supplies, services,  merchandise or equipment
involving  payments of more than $100,000 over its  remaining  term  (including,
without  limitation,  periods  covered by any option to renew by either  party);
(iv)  Agreement  for the  purchase,  sale or lease of any real  estate  or other
Material Assets; (v) profit-sharing,  bonus,  incentive  compensation,  deferred
compensation,  stock option,  severance pay, stock purchase,  employee  benefit,
insurance,  hospitalization,  pension,  retirement  or  other  similar  plan  or
Agreement;  (vi)  Agreement  for the sale of any of its  Material  Assets or the
grant of any  preferential  rights to  purchase  any of its  Material  Assets or
rights,  other than in the Ordinary  Course of Business;  (vii)  Agreement which
contains any  provisions  requiring the Company,  any  Subsidiary or any Medical
Group to indemnify any other party thereto other than in the Ordinary  Course of
Business;  (viii) joint  venture  agreement  or other  Agreement  involving  the
sharing of profits;  (ix) outstanding loan to any person or entity or receivable
due from any  stockholder  of the  Company or persons or  entities  controlling,
controlled  by or under common  control with the Company;  or (x) any  Agreement
(including,  without  limitation,  Agreements  not to  compete  and  exclusivity
Agreements)  that  reasonably  could  be  interpreted  to  impose  any  material
restriction on the Company's  ability to conduct its business  operations in the
Ordinary Course of Business.

                  (c)  Section  3.16(c)  of the  Disclosure  Schedule  lists all
physicians  who, as of the date  hereof,  have  entered  into (i)  participation
agreements  with a Medical Group or other medical  practice  affiliated with the
Company, (ii) binding letters of intent to become affiliated with the Company, a
Medical  Group or a medical  practice  affiliated  with the  Company,  and (iii)
non-binding  letters of intent to become affiliated with the Company,  a Medical
Group or a medical practice affiliated with the Company.

                                       13

<PAGE>


         3.17.     Books and Records

                  The books of account,  stock  records,  minute books and other
records  of the  Company  and the  Subsidiaries  are  true and  complete  in all
material  respects and have been  maintained  in  accordance  with good business
practices,  and the matters  contained  therein are appropriately and accurately
reflected  in the  financial  statements  of the Company  delivered  pursuant to
Section 4.6.


         3.18.     Litigation; Disputes

                  (a) Except as set forth in Section  3.18(a) of the  Disclosure
Schedule,  there are no actions,  suits,  claims,  arbitrations,  proceedings or
investigations pending, or, to the Company's knowledge, threatened or reasonably
anticipated  against,  affecting or involving the Company, any Subsidiary or any
Medical  Group or their  respective  businesses or Assets,  or the  transactions
contemplated by this Purchase  Agreement,  at law or in equity or admiralty,  or
before or by any  court,  arbitrator  or  governmental  authority,  domestic  or
foreign.  Neither the Company nor any  Subsidiary  or Medical Group is operating
under,  subject  to or in  default  with  respect  to any  order,  award,  writ,
injunction,  decree  or  judgment  of  any  court,  arbitrator  or  governmental
authority.

                  (b) Except as set forth in Section  3.18(b) of the  Disclosure
Schedule,  neither the Company nor any  Subsidiary or Medical Group is currently
involved in or, to the knowledge of the Company, the Subsidiaries or the Medical
Groups,  reasonably  anticipates  any dispute  with any of its current or former
employees,   agents,  brokers,   distributors,   vendors,  customers,   business
consultants,   franchisees,   franchisors,    representatives   or   independent
contractors (or any current or former employees of any of the foregoing  persons
or entities)  affecting the businesses or Assets of the Company,  any Subsidiary
or any Medical Group.


         3.19.     Labor Relations

                  There are no strikes, work stoppages,  grievance  proceedings,
union organization  efforts or other controversies  pending or, to the Company's
knowledge,  threatened  or  reasonably  anticipated  between  the  Company,  any
Subsidiary or any Medical  Group and (i) any current or former  employees of the
Company  or of any  Subsidiary  or  Medical  Group  or (ii)  any  union or other
collective  bargaining  unit  representing  such  employees.  The  Company,  the
Subsidiaries and the Medical Groups have complied and are in compliance with all
Laws relating to employment or the  workplace,  including,  without  limitation,
provisions relating to wages, hours,  collective bargaining,  safety and health,
work  authorization,  equal employment  opportunity,  immigration,  withholding,
unemployment compensation,  worker's compensation, employee privacy and right

                                       14

<PAGE>


to know, except where a failure to comply, singly or in the aggregate, would not
have a material adverse effect to the Company,  the Subsidiaries and the Medical
Groups,  taken as a whole.  There are no  collective  bargaining  agreements  or
employment  agreements  (other than  agreements  as may be imposed by applicable
law) between the Company,  any  Subsidiary or any Medical Group and any of their
respective employees,  or professional service agreements not terminable at will
relating to the  businesses  and Assets of the Company or of any  Subsidiary  or
Medical  Group,  other  than  as set  forth  on  the  Disclosure  Schedule.  The
consummation of the transactions contemplated hereby will not cause the Company,
any of the  Subsidiaries or the Medical Group or the Investor to incur or suffer
any liability relating to, or obligation to pay, severance, termination or other
payments to any person or entity.


         3.20.     Pension and Benefit Plans

                  3.20.1.  Disclosure  Schedule.  Except as set forth in Section
3.20.1 of the  Disclosure  Schedule,  neither the Company nor any  Subsidiary or
Medical Group (i) maintains any Plan or material  Other  Arrangement,  (ii) is a
party to any Plan or material Other  Arrangement or (iii) has obligations  under
any Plan or material Other Arrangement.

                  3.20.2. Copies of Documents.  The Company has delivered to the
Investor true and complete  copies of each of the following  Documents:  (i) the
Documents  setting  forth the terms of each Plan;  (ii) for the most recent plan
year,  all annual  reports  (Form 5500 series) on each Plan that have been filed
with any  governmental  agency;  (iii) the current summary plan  description and
subsequent  summaries of material  modifications for each Title I Plan; (iv) all
DOL opinions on any Plan and all correspondence  relating to the request for and
receipt of each  opinion;  (v) all IRS  rulings,  opinions or  technical  advice
relating  to any  Plan;  and (vi)  all  Agreements  with  service  providers  or
fiduciaries  for  providing  services on behalf of any Plan.  For each  material
Other  Arrangement,  the Company has delivered to the Investor true and complete
copies of each policy,  Agreement or other Document  setting forth or explaining
the terms of the Other Arrangement.

                  3.20.3.  General.  Except as provided in Section 3.20.1 of the
Disclosure  Schedule,  no Plan is (i) a Multiemployer  Plan, (ii) an ESOP, (iii)
subject  to  Title  IV  of  ERISA,  (iv)  funded  through  a  trust  or  similar
arrangement,  or (v) provides  post-retirement  medical, life insurance or other
benefits  promised (except for health care  continuation  coverage)  provided or
otherwise  due now or in the future to current,  former or retired  employees of
the Company or any Subsidiary.

                                       15

<PAGE>


                  3.20.4.    Unpaid Contributions.  The Disclosure Schedule sets
forth the contributions that (i) the Company or any Subsidiary has  promised  or
is otherwise obligated to make under any Plan and (ii) are unpaid as of the date
of this Purchase Agreement.

                  3.20.5.    Contributions and Other Obligations.   The  Company
and the Subsidiaries have made all contributions required by and due  under  the
terms of its Plans.

                  3.20.6.  Qualified  Plans.  The  Company's  401(k) Plan is the
Company's  only  Qualified  Plan.  Except as described in Section  3.20.6 of the
Disclosure  Schedule,  the 401(k) Plan complies and has complied in all material
respects with ERISA, the Code (including,  without limitation,  the requirements
for Tax qualification described in Section 401 thereof), and all other Laws. The
Company intends to receive a  determination  letter from the IRS with respect to
the 401(k) Plan.  The remedial  amendment  period for the adoption of the 401(k)
Plan has not lapsed.

                  3.20.7.  Compliance  with Law.  Except as set forth in Section
3.20.7 of the  Disclosure  Schedule,  the Company has  complied in all  material
respects with all applicable  provisions of the Code,  ERISA, the National Labor
Relations Act, Title VII of the Civil Rights Act of 1964, the Age Discrimination
in  Employment  Act,  the Fair Labor  Standards  Act,  the  Securities  Act, the
Securities  Exchange Act of 1934,  and all other Laws  pertaining  to the Plans,
Other  Arrangements and other employee or employment  related benefits,  and all
premiums  and  assessments  relating  to all  Plans or Other  Arrangements.  The
Company has no pending unfair labor practice charges,  contract grievances under
any collective  bargaining  agreement,  other  administrative  charges,  claims,
grievances or lawsuits before any court,  governmental agency,  regulatory body,
or arbiter  arising under any Law  governing any Plan,  and there exist no facts
that could give rise to such a claim.

                  3.20.8. ERISA; Prohibited Transaction. Neither the Company nor
any Subsidiary nor any of the Plans has engaged in a violation of Section 406(a)
or 406(b) of ERISA for which no exemption exists under Section 408 of ERISA or a
"prohibited  transaction" (as such term is defined in Section  4975(c)(1) of the
Code), for which no exemption exists under Section  4975(c)(2) or 4975(d) of the
Code.

                  3.20.9. Health Care Continuation Coverage Requirements. Except
as set forth in Section 3.20.9 of the Disclosure Schedule,  all Welfare Plans of
the Company  that are subject to Section  4980B(f) of the Code and  Sections 601
through 607 of ERISA comply with and have been  administered  in compliance

                                       16

<PAGE>


with the health care continuation-coverage  requirements for tax-favored  status
under  Section  4980B(f)  of  the  Code  (formerly Section 162(k)  of the Code),
Sections 601 through  607 of  ERISA,  except  where a  failure to comply, singly
or in the aggregate,  would  not have a  material  adverse effect on the Company
or its Subsidiaries.

                  3.20.10.  Filed  Returns and  Reports.  Except as set forth in
Section  3.20.10 of the Disclosure  Schedule,  the Company and the  Subsidiaries
have (i) filed or caused to be filed all  returns  and reports on Plans in which
employees of the Company or Subsidiaries  participate  that they are required to
file and (ii) paid or made adequate provision for all fees, interest, penalties,
assessments  or  deficiencies  that have become due pursuant to those returns or
reports or pursuant to any assessment or adjustment  that has been made relating
to those returns or reports. All other fees, interest, penalties and assessments
that are  payable  by or for the  Company  or any  Subsidiary  have been  timely
reported,  fully  paid and  discharged.  There  are no unpaid  fees,  penalties,
interest or assessments due from the Company or any subsidiary or from any other
person  that are or  could  become a lien on any  Asset  of the  Company  or any
Subsidiary or could otherwise  adversely  affect the businesses or Assets of the
Company or any Subsidiary.


         3.21.     Environmental


                  (a)  To  the  Company's   knowledge,   the  Company  and  each
Subsidiary  and Medical  Group are in compliance  with,  have been in compliance
with, and have no material liability under, the Environmental Laws.


                  (b) To the Company's  knowledge,  the Real Property  currently
operated by the Company and each  Subsidiary and Medical Group does not contain,
and during the period of any ownership,  tenancy or operation,  no Real Property
formerly  owned  or  operated  contained,   any  underground  improvements  used
currently  or in the past for the  management  of  Hazardous  Materials,  and no
portion of any  currently  leased or operated  property is or has been used as a
dump or  landfill  or consists  of filled in land,  except  where the  existence
thereof  could  not  have  a  material  adverse  effect  on  the  Company,   its
Subsidiaries  and the Medical Groups,  taken as a whole.  Except as disclosed in
Section 3.21(b) of the Disclosure Schedule, neither PCBs nor asbestos-containing
materials  (that would be material to the Company) are present on or in any Real
Property  currently  operated by the Company,  its  Subsidiaries  or the Medical
Groups.


                  (c)  Neither the  Company,  its  Subsidiaries  nor the Medical
Groups,  nor any  officer,  director  or  stockholder  thereof  has  directly or
indirectly  received  any Claim or knows or  suspects  any  fact(s)  which might
reasonably form the basis

                                       17

<PAGE>


for  any  Claim  arising  out  of  or  attributable  to: (i) the current or past
presence, release, or threatened release of Hazardous Materials at or  from  any
part of the Real Property; (ii) the off-site disposal or treatment of  Hazardous
Materials originating on or from the Real Property or  the  businesses or Assets
of the Company or any Subsidiary; or (iii)  any  violation of Environmental Laws
at any part of the Real  Property  or  otherwise arising from the Company's, any
Subsidiary's  or  any  Medical  Group's  activities  (or  the  activities of the
Company's, any Subsidiary's  or  any  Medical  Group's  predecessors  in  title)
involving Hazardous Materials.


         3.22.     Transactions with Related Parties

                  Except as contemplated by this Purchase Agreement or set forth
in  Section  3.22 of the  Disclosure  Schedule,  neither  any  present or former
officer,  director  or  stockholder  of the Company or any  Subsidiary,  nor any
Affiliate of such officer, director or stockholder,  is currently a party to any
transaction with the Company or any Subsidiary,  including,  without limitation,
any Agreement providing for the employment of, Furnishing of Services by, rental
of Assets from or to, or  otherwise  requiring  payments  to, any such  officer,
director,  stockholder  or Affiliate,  other than  transactions  in the Ordinary
Course of Business with the Company.


         3.23.     Restrictions and Consents

                  There are no  Agreements,  Laws or other  restrictions  of any
kind to which the Company,  any  Subsidiary  or any Medical  Group (or any asset
thereof)  is party or subject  that would  prevent or  restrict  the  execution,
delivery or  performance  of this  Purchase  Agreement or result in any penalty,
forfeiture,  Agreement termination, or restriction on business operations of the
Investor,  the Company,  any  Subsidiary or any Medical Group as a result of the
execution,  delivery or performance of this Purchase Agreement.  Section 3.23 of
the Disclosure Schedule lists all such Agreements and Laws that reasonably could
be interpreted or expected to require the consent or  acquiescence of any person
or entity not party to this Purchase Agreement with respect to any aspect of the
execution,  delivery or performance  of this Purchase  Agreement by the Company,
any Subsidiary or any Medical Group.


         3.24.     Authorization

                  The execution, delivery and performance by the Company of this
Purchase Agreement and all other Documents  contemplated hereby, the fulfillment
of and compliance with the respective  terms and provisions  hereof and thereof,
and the consummation by the Company of the transactions  contemplated hereby and
thereby,  do not and will not:  (a)  require  any  consent  or  approval  of the

                                       18

<PAGE>


stockholders  of the Company that has not been  obtained;  (b) conflict with, or
violate any  provision  of, any Law having  applicability  to the  Company,  any
Subsidiary  or any  Medical  Group or any of  their  respective  Assets,  or any
provision of the certificate or articles of organization or bylaws or equivalent
constituent  document of the Company,  any Subsidiary or any Medical Group;  (c)
conflict  with,  or result in any breach of, or  constitute a default  under any
Agreement to which the Company,  any  Subsidiary or any Medical Group is a party
or by which it or any of its  Assets  may be bound;  or (d) result in or require
the creation or imposition of or result in the acceleration of any indebtedness,
or of a material Encumbrance, or with respect to, the Company, any Subsidiary or
any Medical  Group or any of the Assets now owned or  hereafter  acquired by the
Company, any Subsidiary or any Medical Group.


         3.25.     Absence of Violations

                  Neither the Company,  any  Subsidiary nor any Medical Group is
in violation of or default under, nor has it breached,  any term or provision of
its certificate or articles of organization or bylaws or any material  Agreement
or  restriction  to which the Company,  any Subsidiary or any Medical Group is a
party or by which the Company or any Subsidiary or any Material Asset thereof is
bound or affected.


         3.26.     Regulatory Matters

                  The  Company  and  the  Subsidiaries  and,  to  the  Company's
knowledge,  the Medical Groups and the physicians employed by the Medical Groups
have not  knowingly or willfully  failed to comply with the  regulatory  matters
described in this Section 3.26.

                  3.26.1.   General  Compliance  with  Law.  The  Company,   the
Subsidiaries and, to the Company's  knowledge,  the Medical Groups have complied
and are in full  compliance  with all Laws  except  where a failure  to  comply,
singly or in the  aggregate,  would not have a  material  adverse  effect on the
Company, the Subsidiaries and the Medical Groups, taken as a whole.

                  3.26.2.  Licenses and Permits.  The Company, the Subsidiaries,
the Medical Groups and each of the physicians  employed by such Persons have all
licenses,   permits,   certificates   of   authority,   franchises,   approvals,
authorizations,  consents or orders of, or filings with ("Permits") any federal,
state, local, foreign or other governmental agency, instrumentality, commission,
authority, board or any other Person, necessary to conduct their business as now
being conducted except where the failure to have any such Permit does not have a
material adverse effect on the Company, the Subsidiaries and the Medical Groups,
taken as a whole.  All Permits of the Company and the  Subsidiaries  and, to the
Company's

                                       19

<PAGE>


knowledge,  the Medical Groups and  each  of  the  physicians  employed  by such
Medical  Groups are valid and in full force and effect  except where the failure
to have any such Permit does not have a material  adverse effect on the Company,
the Subsidiaries  and the Medical  Groups,  taken  as  a  whole.  No  notice to,
declaration,  filing  or  registration  with,  or  Permit  or  consent from, any
governmental or regulatory body or authority,  or any other Person or entity, is
required to be made or obtained  by the  Company or any of the  Subsidiaries  or
Medical Groups in connection with the execution, delivery or performance of this
Purchase Agreement and the consummation of the transactions contemplated hereby.
Notwithstanding the foregoing,  the Company is not required to obtain any Permit
to do business as a health maintenance organization, insurance company, or other
risk-bearing  health care entity under the Laws and  regulations  of Maryland or
the Laws and  regulations of any other  jurisdiction  in which the Company,  the
Subsidiaries or the Medical Groups do business.

                  3.26.3.  Fraud and Abuse Matters. To the Company's  knowledge,
the Company, the Medical Groups, and all persons and entities providing services
for the Company or the Medical Groups,  have not engaged in any activities which
are  prohibited or could form the basis for criminal  penalties,  civil monetary
penalties or a mandatory or permissive exclusion from the Medicare,  Medicaid or
other federal and state health care programs  under ss. ss.  1320a-7,  1320a-7a,
1320a-7b,  or 1395nn of Title 42 of the United States Code, the federal  CHAMPUS
statute,  or any  regulations  promulgated  thereunder,  or  similar  or related
federal, state and local statutes, common law or regulations. Without in any way
limiting the foregoing,  the Company,  the Medical Groups, and, to the knowledge
of the Company,  all persons and entities  providing services for the Company or
the Medical Groups have not engaged in any of the following activities:

                  (i)      knowingly   and   willingly   made  or  caused  to be
                  made any  false statement or representation of a material fact
                  in any application for any benefit or payment;

                  (ii)     knowingly   and   willingly   made  or  caused to  be
                  made any  false statement or representation of a material fact
                  for use in determining rights to any benefit or payment;

                  (iii)  presenting  or  causing  to be  presented  a claim  for
                  reimbursement  under  CHAMPUS,  Medicare,  Medicaid,  or other
                  state  healthcare  program that is for an item or service that
                  the person  presenting  or causing  to be  presented  knows or
                  should know was not provided as claimed, or presenting a claim
                  that the person  presenting  knows or should  know is false or
                  fraudulent;

                                       20

<PAGE>


                  (iv) having knowledge of the occurrence of any event affecting
                  (a)  his/her  initial  or  continued  right to any  benefit or
                  payment or (b) the initial or  continued  right to any benefit
                  or payment of any other  individual in whose behalf he/she has
                  applied for or is receiving such benefit or payment,  conceals
                  or fails to disclose such event with an intent fraudulently to
                  secure such benefit or payment  either in a greater  amount or
                  quantity  that is due or when no such  benefit  or  payment is
                  authorized;

                  (v) offering, paying, soliciting or receiving any remuneration
                  (including  any  kickback,  bribe,  or  rebate),  directly  or
                  indirectly,  overtly  or  covertly,  in cash or in kind (a) in
                  return  for  referring,  or to  induce  the  referral  of,  an
                  individual to a person for the furnishing or arranging for the
                  furnishing  of any item or service  for which  payment  may be
                  made in whole or in part by CHAMPUS,  Medicare or Medicaid, or
                  other state health care  program,  or (b) in return for, or to
                  induce, the purchase,  lease, or order of, or arranging for or
                  recommending  the  purchase,  lease,  or order  of,  any good,
                  facility,  service,  or item for which  payment may be made in
                  whole or in part by CHAMPUS,  Medicare or  Medicaid,  or other
                  state health care program;

                  (vi)  making or causing to be made or  inducing  or seeking to
                  induce the making of any false statement or representation (or
                  omitting  to state a fact  required  to be stated  therein  or
                  necessary  to  make  the  statements   contained  therein  not
                  misleading)  of a  material  fact  with  respect  to  (a)  the
                  conditions  or  operations  of a  facility  in order  that the
                  facility may qualify for CHAMPUS, Medicare,  Medicaid or other
                  state health care program  certification,  or (b)  information
                  required to be provided under ss. 1124A of the Social Security
                  Act (42 U.S.C. ss. 1320a-3);

                  (vii)  submitting or causing to be submitted bills or requests
                  for payment  under  Medicare,  Medicaid or other state  health
                  care program  containing  charges  substantially  in excess of
                  usual charges; or

                  (viii) furnishing or causing to be furnished items or services
                  to  patients  substantially  in  excess  of the  needs of such
                  patients.

                  3.26.4.      Health Care Entity.  The Company is not a "health
care entity" which provides "designated health services" for purposes of federal
Medicare/Medicaid physician self-referral and anti-kickback laws and regulations
and similar Maryland Laws and regulations.

                                       21

<PAGE>


                  3.26.5.      Hart-Scott-Rodino.  No  filings under Hart-Scott-
Rodino are required in connection with the Closing or any Advance.


         3.27.     Certain Future Relationships

                  Subject to compliance with applicable Law, neither the Company
nor any Medical  Group is subject to or bound by any  agreement,  commitment  or
obligation that would prohibit,  or be violated by, any agreement or arrangement
with GHV or its Affiliates on commercially reasonable terms for the provision of
health  care  services  and  supplies  of  the  type  provided  by GHV  and  its
Affiliates,  including,  without limitation,  long-term care, pharmacy services,
durable medical equipment and home health care ("GHV Services").


         3.28.     SEC Registration

                  The  Company  has  filed  with  the  Securities  and  Exchange
Commission  a  registration  statement  on Form S-1 with  respect to the Class B
Common  Stock and options to purchase  Class B Common  Stock (the  "Registration
Statement") and the  Registration  Statement has been declared  effective by the
Securities and Exchange  Commission.  A copy of  Registration  Statement and all
amendments thereto has been delivered to the Investor.


         3.29.     Binding Obligation

                  This  Purchase  Agreement  constitutes  a  valid  and  binding
obligation of the Company,  enforceable in accordance  with its terms;  and each
Document to be  executed  by the Company  pursuant  hereto,  when  executed  and
delivered in accordance with the provisions hereof, shall be a valid and binding
obligation of the Company, enforceable in accordance with its terms.


         3.30.     Status of Shares

                  The shares of Series C Preferred issuable to the Investor upon
conversion of the Note, as provided therein and in Section 2.5, or in payment of
interest  at the  Maturity  Date  as  provided  in  Section  2.3,  will  be duly
authorized by all  necessary  corporate  action on the part of the Company,  and
such shares, upon such conversion or the Maturity Date, as the case may be, will
be validly issued,  fully paid and  nonassessable.  The shares of Class C Common
Stock  issuable  upon  conversion  of the  Series C  Preferred  have  been  duly
authorized by all necessary corporate action on the part of the Company and such
shares of Class C Common Stock have been validly reserved for issuance, and upon
issuance upon such conversion will be validly issued and outstanding, fully paid
and nonassessable.

                                       22

<PAGE>


         3.31.     Offering of Shares

                  Neither the  Company  nor any Person  acting on its behalf has
offered the Series C Preferred or any similar securities of the Company for sale
to, solicited any offers to buy the Series C Preferred or any similar securities
of the Company from or otherwise  approached or  negotiated  with respect to the
Company with any Person  other than the  Investor and a limited  number of other
"Accredited  Investors"  (as defined in Rule 501(a) under the  Securities  Act).
Neither the Company nor any other Person  acting on its behalf has taken or will
take any action prior to conversion of the Note or the Maturity Date (including,
without  limitation,  any  offering  of  any  securities  of the  Company  under
circumstances  which would  require the  integration  of such  offering with the
offering of the Series C Preferred  under the  Securities  Act and the rules and
regulations  of the  Commission  thereunder)  which might  subject the offering,
issuance and sale of the Series C Preferred to the registration  requirements of
Section 5 of the Securities Act.


         3.32.     Disclosure

                  No  representation or warranty by the Company in this Purchase
Agreement,  and no Document  delivered or to be delivered to, or made  available
for  inspection  by, the Investor  pursuant to this  Purchase  Agreement,  or in
connection herewith or with the transactions  contemplated  hereby,  contains or
will contain any untrue or  misleading  statement  of material  fact or omits or
will omit any fact  necessary to make the  statements of material fact contained
herein  or  therein,  in  light  of the  circumstances  under  which  made,  not
misleading.


4.        REPRESENTATIONS AND WARRANTIES OF THE INVESTOR

                  The Investor hereby  represents and warrants to the Company as
follows:


         4.1.      Organization and Standing

                  The Investor is a corporation duly organized, validly existing
and in good  standing  under the laws of the State of Delaware  and has the full
and  unrestricted  corporate  power and  authority  to carry on its  business as
currently conducted,  to enter into this Purchase Agreement and to carry out the
transactions contemplated hereby.

                                      23

<PAGE>


         4.2.      Authorization

                  The  execution,  delivery and  performance  by the Investor of
this  Purchase  Agreement  and all  other  Documents  contemplated  hereby,  the
fulfillment  of and the  compliance  with the  respective  terms and  provisions
hereof and thereof,  and the  consummation  by the Investor of the  transactions
contemplated hereby and thereby have been duly authorized,  (which authorization
has not been  modified or rescinded  and is in full force and effect),  and will
not: (a) conflict  with,  or violate any  provision of, any term or provision of
the certificate of incorporation or bylaws of the Investor or (b) conflict with,
or result in any breach of, or  constitute  a default  under,  any  Agreement to
which the  Investor  is a party or by which  the  Investor  is  bound.  No other
corporate  action is  necessary  for the  Investor  to enter into this  Purchase
Agreement and all other  Documents  contemplated  hereby and to  consummate  the
transactions contemplated hereby and thereby.


         4.3.      Binding Obligation

                  This  Purchase  Agreement  constitutes  a  valid  and  binding
obligation  of the Investor,  enforceable  in  accordance  with its terms.  Each
Document to be executed by the  Investor  pursuant  hereto,  when  executed  and
delivered in accordance with the provisions hereof, shall be a valid and binding
obligation of the Investor, enforceable in accordance with its terms.


         4.4.      Hart-Scott-Rodino

                  No filings under  Hart-Scott-Rodino are required in connection
with the Closing or any Advance;  provided, that no representation is made as to
whether a Hart-Scott-Rodino filing will be required upon conversion of the Note.


         4.5.      Certain Future Relationships

                  Subject  to  compliance  with  applicable  Law,   neither  the
Investor  nor  GHV is  subject  to or  bound  by any  agreement,  commitment  or
obligation that would prohibit,  or be violated by, any agreement or arrangement
with  the  Company  or  any  of  the  Subsidiaries  or  the  Medical  Groups  on
commercially reasonable terms for the provision of GHV Services.


5.        RESTRICTED SECURITIES

                  The Investor  hereby  represents,  warrants  and  covenants as
follows:

                                       24

<PAGE>


         5.1.      No Registration Under the Securities Act

                  The Investor  understands  that the Note to be purchased by it
under this Purchase  Agreement has not been registered under the Securities Act,
is issued  in  reliance  upon  exemptions  contained  in the  Securities  Act or
interpretations  thereof  (including Section 4(2) of the Securities Act) and the
securities laws of the Commonwealth of  Pennsylvania,  and cannot be offered for
sale,  sold or otherwise  transferred  unless the Note being acquired  hereunder
subsequently is so registered or qualifies for exemption from registration under
the Securities Act.


         5.2.      Acquisition for Investment

                  The Note is being  acquired  under this Purchase  Agreement by
the Investor in good faith solely for its own account,  for  investment  and not
with a view  toward  resale or other  distribution  within  the  meaning  of the
Securities  Act.  The Note  will not be  offered  for  sale,  sold or  otherwise
transferred  by the Investor  without  either  registration  or  exemption  from
registration under the Securities Act.


         5.3.      Evaluation of Merits and Risks of Investment

                  The Investor has such  knowledge  and  experience in financial
and business  matters that it is capable of  evaluating  the merits and risks of
its  investment  in the  Note  being  acquired  hereunder.  The  Investor  is an
"accredited investor" within the meaning of one or more paragraphs (1), (2), (3)
or (8) of Rule 501(a) under the Securities Act. The Investor  understands and is
able to bear any economic  risks  associated  with such  investment  (including,
without limitation,  the necessity of holding such Note for an indefinite period
of time,  inasmuch  as such Note has not been  registered  under the  Securities
Act).


6.        ADDITIONAL COVENANTS OF THE COMPANY

                  Without limiting any other covenants and agreements  contained
herein but not intending to duplicate  covenants contained in the Stock Purchase
Agreement,  during the term of this Purchase  Agreement and, until all principal
and accrued interest under the Note and all obligations required to be performed
under this Purchase Agreement have been paid and performed in full, or until the
entire  Outstanding  Principal  Amount has been converted as provided in Section
2.5 and the  Investor's  obligation  to make Future  Advances has  terminated or
expired, the Company covenants and agrees as follows:

                                       25

<PAGE>

         6.1.      Reports

                  The Company shall, in addition to reports customarily prepared
for the  Board of  Directors,  deliver  to the  Investor  and GHV  copies of all
reports required to be filed pursuant to the federal securities laws.


         6.2.      Certain Future Relationships

                  (a)      Each of the Company, the Subsidiaries and the Medical
Groups shall:

                           (i) use its good  faith  best  efforts  to notify GHV
                  reasonably in advance of any agreement or arrangement  that it
                  has decided to enter into for the provision of GHV Services;

                           (ii)  use all good  faith  best  efforts  to keep GHV
                  informed of all material  discussions of a substantive  nature
                  that it may have regarding the provision of GHV Services;

                           (iii)  provide  GHV  and  its  Affiliates   with  all
                  information  that may  reasonably  be  required  to enable the
                  Investor and its  Affiliates an opportunity to make a proposal
                  to provide GHV Services to the Company,  the  Subsidiaries  or
                  the Medical Groups on commercially reasonable terms;

                           (iv)  provide  GHV  with  an  opportunity  to  secure
                  contracts   for  the  provision  of  GHV  Services  that  were
                  previously granted to others,  all on commercially  reasonable
                  terms; and

                           (v)      cooperate in any creative proposals that GHV
                  or  its  Affiliates  may  make  regarding  pricing  or service
                  alternatives.

                  (b) To better implement and effectuate the foregoing,  GHV and
the Company  each agree to  designate  one or more persons to serve as part of a
joint  working  group,  which group will be charged  with  investigating,  on an
ongoing  and  regular   basis,   innovative   and   cost-effective   contracting
opportunities   between  and  among  the  Company,   GHV  and  their  respective
Affiliates,  and  reporting  the  results  of  such  activities  to  the  senior
management of GHV and the Company.

                  (c) Nothing  contained in this Section 6.3 shall  obligate the
Company or GHV to utilize or purchase the products or services of each other and
should not be interpreted as an agreement that such purchases will not from time
to time be made from third parties.

                                       26

<PAGE>


                  (d) The  Company  will not after the  Closing  enter  into any
exclusive  arrangements  with third parties that preclude GHV and its Affiliates
from providing goods or services to the Company and its  Affiliates,  unless (1)
such  arrangements  are at such time or times also offered to, or otherwise made
available  to,  GHV,  and (2) the  price and  other  terms of such  arrangements
constitute  arms-length  fair market terms that do not take into  account  other
arrangements that may have been offered or promised by such third party in order
to obtain such commitments,  including,  but not limited to,  investments in the
Company.

                  (e) The  Company  and GHV agree  that the  provisions  of this
Section  6.3 have been  developed  in order to assist the  parties in  providing
efficient and cost-effective  medical care, across the entire continuum of care,
to patients served by the Company's integrated health care delivery system.


         6.3.      Actions Prompting Redemptions

                  (a)      Prior  to  the Maturity Date, without the approval of
the Investor, the Company shall not:

                           (i)      redeem any shares of the Company's Series  A
                  Preferred Stock  or  Series  B  Preferred  Stock  pursuant  to
                  Sections B.3(c) or C.3(c) of the Restated Charter;

                           (ii) take any of the  actions  set  forth in  Section
                  B.1.(e)(i)  of the  Restated  Charter  without  the  requisite
                  approval  of the  holders  of the  Series  A  Preferred  Stock
                  pursuant  to  the   Restated   Charter,   unless  the  Company
                  determines  in good  faith  that  such  action  is in the best
                  interests  of the Company and all of its  stockholders  and is
                  not  designed  to  primarily  benefit  holders of the Series A
                  Preferred Stock;

                           (iii)  take any of the  actions  set forth in Section
                  C.1.(e)(i)  of the  Restated  Charter  without  the  requisite
                  approval  of the  holders  of the  Series  B  Preferred  Stock
                  pursuant  to  the   Restated   Charter,   unless  the  Company
                  determines  in good  faith  that  such  action  is in the best
                  interests  of the Company and all of its  stockholders  and is
                  not  designed  to  primarily  benefit  holders of the Series B
                  Preferred Stock; or

                           (iv) engage in practices that violate the Ethical and
                  Religious Directives for Catholic Health Care Services, unless
                  the  Company  determines  in good faith that such action is in
                  the best interests of

                                       27

<PAGE>
                  the  Company  and all of its  stockholders and is not designed
                  to primarily benefit holders of the Series A Preferred Stock.


                  (b) If the Company elects to take any of the actions set forth
in Section 6.4(a)(ii) or 6.4(a)(iii) (other than an issuance of Series A Adverse
Junior Stock or Series B Adverse  Junior Stock (as such terms are defined in the
Restated  Charter)),  the Company  shall  provide to the  Investor no later than
sixty (60) days prior to the date such  action is to be  effective  (1)  written
notice to that effect and (2) a  certificate  from the  Company's  president and
chief executive officer certifying that the Company has determined in good faith
that  such  action  is in the  best  interests  of the  Company  and  all of its
stockholders  and is not  designed  to  primarily  benefit  holders  of Series A
Preferred Stock or Series B Preferred Stock, as the case may be.

                  (c) If the  Company  elects to issue  Series A Adverse  Junior
Stock or Series B  Adverse  Junior  Stock,  the  Company  shall  provide  to the
Investor no later than thirty (30) days prior to the date such issuance is to be
consummated  (1) written notice to that effect,  and (2) a certificate  from the
Company's  president and chief executive officer certifying that the Company has
determined  in good faith that such  issuance  is in the best  interests  of the
Company and all of its  stockholders  and is not designed to  primarily  benefit
holders of Series A Preferred Stock or Series B Preferred Stock, as the case may
be.

                  (d) If the  Company  engages in  practices  that  violate  the
Ethical and Religious Directives for Catholic Health Care Services,  the Company
shall  provide to the  Investor no later than thirty (30) days prior to the date
of the  consummation  of a redemption  resulting from such practices (1) written
notice that the Company has engaged in such practices and, consequently,  shares
of Series A Preferred Stock are being redeemed,  and (2) a certificate  from the
Company's  president and chief executive officer certifying that the Company has
determined  in good  faith  that  such  action is in the best  interests  of the
Company and all of its  stockholders  and is not designed to  primarily  benefit
holders of Series A Preferred Stock.

                  (e) Within ten (10) days after the Investor receives a written
notice  pursuant  to  Section  6.4(b),  (c) or (d),  the  Investor  may  require
arbitration  under the  expedited  procedures  set forth  herein of whether  the
action  described in the notice is in the best  interests of the Company and all
of its  stockholders  and whether such action is designed to  primarily  benefit
holders of Series A Preferred Stock or Series B Preferred Stock, as the case may
be. Such arbitration shall be conducted by three arbitrators,  two of whom shall
be selected by the parties (the "Party Designated Arbitrators") and the third of
whom shall be a "Neutral Arbitrator" selected the Party Designated  Arbitrators.
The  Party  Designated

                                       28

<PAGE>


Arbitrators  shall agree upon and  appoint  a  Neutral Arbitrator,  who shall be
an  attorney  experienced  in  the  commercial   financing   transactions.   The
arbitration  shall  be  concluded  within  thirty  (30)  days of the date of the
Company's notice.  The determination of the arbitrators so  appointed  shall  be
final and conclusive upon the parties and the Company hereby  agrees not to take
the action which is the subject of the  arbitration  if it  is  determined  that
such  action is not in the  best  interests  of  the  Company  and  all  of  its
stockholders or such action is designed to primarily benefit holders of Series A
Preferred Stock or Series B Preferred Stock, as the case may be.


         6.4.      Use of Proceeds

                           The Company may use the proceeds of the Advances only
for the purposes  of funding  working  capital  needs,  operating  losses,  debt
retirement,  and acquisitions of physician  practices,  all  as  reflected  in a
budget  approved by the  Company's Board of  Directors or as  otherwise approved
by the Company's Board of Directors. Without the  approval of the Investor,  the
Company shall not use the proceeds of any  Advance (i) to  redeem the  Company's
Series A  Preferred  Stock,  Series B Preferred  Stock or  any securities of the
Company  with  dividend,  redemption  or  liquidation   rights   senior  to  the
dividend,  redemption or liquidation rights of the Series  C  Preferred Stock or
(ii) to pay any dividends or interest thereon.


         6.5.      Acquisition of Specialist Groups

                  Prior to the Maturity  Date,  the Company shall not acquire or
affiliate  with any  specialist  physician  group  practice other than Baltimore
Heart  Associates  (with  whom  the  Company  has  entered  into an  affiliation
agreement  which  contemplates  cash  payments  not  to  exceed  $70,000  in the
aggregate) in a  transaction  that requires the Company to pay more than $10,000
per physician of the purchase price (or similar  consideration)  in cash without
GHV's prior written approval (which will not be unreasonably withheld).


         6.6.      No Material Change to Business Plan

                  Prior to the  Maturity  Date,  the Company  shall not make any
material  change to its business plan or the Operating  Plan without GHV's prior
written approval (which approval will not be unreasonably withheld).


         6.7.      Reservation of Shares

                  The Company shall at all times reserve and keep  available for
issuance a number of its  authorized  but unissued  shares of Series C Preferred

                                       29

<PAGE>


sufficient  to permit the  Investor to exercise  in full its  conversion  rights
under Section 2.5.


7.        CONDITIONS PRECEDENT TO THE COMPANY'S OBLIGATIONS AT THE CLOSING

                  The  obligations of the Company under this Purchase  Agreement
are subject to the fulfillment,  at or prior to the Closing Date, of each of the
following conditions, and failure to satisfy any such condition shall excuse and
discharge  all  obligations  of the Company to carry out the  provisions of this
Purchase Agreement, unless such failure is agreed to in writing by the Company:


         7.1.      Representations and Warranties

                  The  representations  and  warranties  made by the Investor in
this Purchase Agreement or in any Document delivered by the Investor pursuant to
this Purchase Agreement shall be true and complete in all material respects when
made  and on and as of the  Closing  Date as  though  such  representations  and
warranties  were made on and as of such date,  except for any changes  expressly
permitted by this Purchase Agreement.


         7.2.      Performance

                  The  Investor  shall  have  performed  and  complied  with all
Agreements and conditions required by this Purchase Agreement to be performed or
complied with by prior to the Closing Date.


         7.3.      Legal Proceedings

                  No  action  or  proceeding  by  or  before  any   governmental
authority  shall  have  been  instituted  or  threatened  (and not  subsequently
dismissed,  settled or otherwise  terminated)  which is  reasonably  expected to
restrain,  prohibit or invalidate the transactions contemplated by this Purchase
Agreement,  other than an action or  proceeding  instituted or threatened by the
Company.


         7.4.      Option Agreement

                  The Option  Agreement  substantially  in the form of Exhibit D
attached hereto shall have been executed and delivered by GHV.

                                       30

<PAGE>


         7.5.      Amended and Restated Stockholders Agreement

                  The Amended and Restated Stockholders Agreement  substantially
in the form of Exhibit E attached  hereto shall have been executed and delivered
by the parties (other than the Company and the Company's  executive officers who
are stockholders of the Company) thereto.


         7.6.      Amended and Restated Registration Rights Agreement

                  The  Amended  and  Restated   Registration   Rights  Agreement
substantially  in the form of Exhibit F attached hereto shall have been executed
and delivered by GHV.


         7.7.      Documents at Closing

                  All documents  required to be furnished by the Investor to the
Company prior to or at the Closing shall have been so furnished.


8.        CONDITIONS PRECEDENT TO THE INVESTOR'S OBLIGATIONS AT THE CLOSING

                  The  obligations  of the  Investor to purchase the Note and to
make the  Initial  Advance at the  Closing  under this  Purchase  Agreement  are
subject to the fulfillment, at or prior to the Closing, of each of the following
conditions, and failure to satisfy any such condition shall excuse and discharge
all  obligations  of the Investor to carry out the  provisions  of this Purchase
Agreement related to the Closing, unless such failure is agreed to in writing by
the Investor:


         8.1.      Representations and Warranties

                  The representations and warranties made by the Company in this
Purchase Agreement and the statements  contained in the Disclosure  Schedule and
Exhibits attached hereto or in any Document delivered by the Company pursuant to
this Purchase Agreement (the "Disclosure  Materials") shall be true and complete
in all material  respects when made, and on and as of the Closing Date as though
such representations and warranties were made on and as of such date, except for
any  changes  occurring  in the  Ordinary  Course of Business  disclosed  to and
approved by the Investor and as otherwise  expressly  permitted by this Purchase
Agreement.

                                       31

<PAGE>


         8.2.      Performance

                  The  Company  shall  have  performed  and  complied  with  all
Agreements and conditions required by this Purchase Agreement to be performed or
complied with prior to the Closing Date.


         8.3.      Absence of Adverse Changes

                  There  shall  have been no adverse  changes  since the date of
this  Purchase  Agreement  material to the  Company,  its  Subsidiaries  and the
Medical  Groups,  taken  as a  whole,  in the  business,  operations,  condition
(financial  or  otherwise),  Assets,  liabilities  or  prospects  of the Company
(regardless of whether or not such events or changes are  inconsistent  with the
representations and warranties given herein by the Company).


         8.4.      Legal Proceedings

                  No  action  or  proceeding  by  or  before  any   governmental
authority  shall  have  been  instituted  or  threatened  (and not  subsequently
settled,  dismissed or otherwise  terminated)  which is  reasonably  expected to
restrain,  prohibit or invalidate the transactions contemplated by this Purchase
Agreement  other than an action or  proceeding  instituted  or threatened by the
Investor.


         8.5.      Officer's Certificate

                  The  Company   shall  have   delivered   to  the   Investor  a
certificate,  dated  as of the  Closing  Date,  and  executed  by the  Company's
President,  in his  capacity  as  such,  certifying  to the  fulfillment  of the
conditions specified in Sections 8.1 through 8.4.


         8.6.      Opinion of Counsel

                  The Investor shall have received an opinion of the director of
legal  affairs of the Company,  dated as of the Closing  Date, to the effect and
substantially in the form of Exhibit G.


         8.7.      Restated Articles

                  The articles of amendment  and  restatement  of the  Company's
articles  of  incorporation  in the  form  attached  hereto  as  Exhibit  H (the
"Restated Articles") shall have received all necessary corporate authorizations,
shall have been filed as necessary under the laws of the State of Maryland,  and
shall be effective.  The Investor  shall have  received (a) a certified  copy of
resolutions  of the

                                       32

<PAGE>


Board of Directors of the Company  duly  authorizing  and adopting  the Restated
Articles,  and  (b) a copy  of the  Restated  Articles, certified by  the  State
Department of  Assessments  and Taxation of the State of Maryland.


         8.8.      Option Agreement

                  The Option  Agreement  substantially  in the form of Exhibit D
attached hereto shall have been executed and delivered by the Company.


         8.9.      Amended and Restated Stockholders Agreement

                  The Amended and Restated Stockholders Agreement  substantially
in the form of Exhibit E attached  hereto shall have been executed and delivered
by the parties (other than the Investor) thereto.


         8.10.     Amended and Restated Registration Rights Agreement

                  The  Amended  and  Restated   Registration   Rights  Agreement
substantially  in the form of Exhibit F attached hereto shall have been executed
and delivered by the Company.


         8.11.     Submission of Advance Request

                  The Company  shall have  delivered  to the Investor an Advance
Request in substantially  the form attached hereto as Exhibit C which contains a
cash flow needs  forecast  for the 60 days  following  the Closing  Date that is
acceptable to the Investor in its discretion.


         8.12.     Documents at Closing

                  All  documents  required to be delivered by the Company to the
Investor prior to or at the Closing shall have been so delivered.


         8.13.     Consents

                  (a)  The   Investor   shall  have   received   all   consents,
authorizations and approvals of governmental and supragovernmental parties which
are required to be obtained in order to consummate the transactions contemplated
hereby.

                  (b) The Company shall have received on or prior to the Closing
Date   all   consents,    authorizations    and   approvals   of   governmental,
supragovernmental and private parties which are required to be obtained in order
to  consummate  the  transactions   contemplated  hereby,   including,   without

                                       33

<PAGE>


limitation, the consents of all parties to Agreements listed on Sections 3.16(a)
and  3.16(b)  of the  Disclosure  Schedule,  and  which  terminate  under  their
respective terms as a result of the transactions  contemplated  hereby,  and the
Company  shall have  delivered  to the Investor a  certificate,  dated as of the
Closing Date and executed by the Company's  President,  in his capacity as such,
certifying  to the  fulfillment  of the  conditions  specified  in this  Section
8.13(b).


9.        CONDITIONS PRECEDENT TO THE INVESTOR'S OBLIGATIONS
          TO MAKE EACH FUTURE ADVANCE

                  The  obligations  of the Investor to make each Future  Advance
under this Purchase Agreement are subject to the fulfillment, at or prior to the
date of such Future  Advance (in each case, an "Advance  Date"),  of each of the
following conditions, and failure to satisfy any such condition shall excuse and
discharge all  obligations  of the Investor to carry out the  provisions of this
Purchase Agreement related to such Future Advance, unless such failure is agreed
to in writing by the Investor:


         9.1.      Absence of Violations

                  The Company shall not be in violation of or default under, and
it  shall  not  have  breached,  any  term  or  provision  of  its  articles  of
incorporation or bylaws, the Loan Agreement dated as of December 1, 1995 between
the Company and  NationsBank,  N.A.,  or under any  successor  credit  facility,
including,  without  limitation,  the facility  currently being  negotiated with
First National Bank of Maryland, N.A.


         9.2.      Performance

                  The  Company  shall have  performed  and  complied  with those
provisions of Section 6 of this Purchase  Agreement  required to be performed or
complied with prior to the Advance Date.


         9.3.      Legal Proceedings

                  No  action  or  proceeding  by  or  before  any   governmental
authority  shall  have  been  instituted  or  threatened  (and not  subsequently
settled,  dismissed or otherwise  terminated)  which is  reasonably  expected to
restrain,  prohibit or invalidate the transactions contemplated by this Purchase
Agreement  other than an action or  proceeding  instituted  or threatened by the
Investor.

                                       34

<PAGE>


         9.4.      Submission of Advance Request

                  The Company  shall have  submitted to the  Investor,  no later
than two business days prior to the proposed Advance Date, an Advance Request in
substantially  the form  attached  hereto  as  Exhibit C which  contains  a cash
requirements  forecast that is approved by the Investor (which approval will not
be unreasonably  withheld if the cash  requirements  forecast is consistent with
the Company's approved Business Plan).


         9.5.      Officer's Certificate

                  The  Company   shall  have   delivered   to  the   Investor  a
certificate,  dated  as of the  Advance  Date  and  executed  by  the  Company's
President,  in his  capacity  as  such,  certifying  to the  fulfillment  of the
conditions specified in Sections 8.1 through 9.3.


10.       EVENTS OF DEFAULT; REMEDIES


         10.1.     Events of Default

                  The  occurrence  of any one or more  of the  following  events
shall constitute an "Event of Default"  hereunder (and the occurrence of any one
or more of the  following  shall  constitute  a  "Default,"  whether  or not any
requirement  for the giving of notice,  the lapse of time, or both, or any other
condition, has been satisfied):

                  (a) The Company  shall fail to pay,  when due, any  principal,
interest or any other amount  payable  hereunder,  under the Note,  the Security
Agreement or under the Assignment (whether upon the Maturity Date thereof,  upon
acceleration or otherwise).

                  (b) The Company  shall  breach or fail to perform any covenant
or agreement  contained in this Purchase  Agreement  and,  except in the case of
failure to comply with  Section 6 (which  shall  constitute  an Event of Default
immediately upon the occurrence thereof), such failure shall continue unremedied
for fifteen (15)  calendar  days after  notice  thereof from the Investor to the
Company.

                  (c) Any  representation  or  warranty  made by the  Company in
Sections 3.1, 3.3, 3.4, 3.6, 3.7, 3.10,  3.12,  3.14, 3.27, 3.28 or 3.32 herein,
in the  Security  Agreement  or in the  Assignment  shall  prove  to  have  been
incorrect in any material respect when made.

                                       35

<PAGE>


                  (d) The  occurrence of any event of default under the Security
Agreement or the Assignment, any breach or default under the Senior Debt, or any
default permitting  acceleration of indebtedness of the Company in the amount of
$1,000,000 or more.

                  (e)  The   commencement  by  the  Company  of  (i)  any  case,
proceeding  or other action (x) under any existing or future law of  insolvency,
reorganization  or relief of debtors  generally or of any type of debtor seeking
to have an order for relief entered with respect to it, or seeking to adjudicate
it a bankrupt or insolvent, or seeking reorganization,  arrangement, adjustment,
winding-up, liquidation,  dissolution,  composition or other relief with respect
to it or its debts, or (y) seeking appointment of a receiver, trustee, custodian
or  other  similar  official  for it or for all or any  substantial  part of its
assets;  or (ii) the Company making a general  assignment for the benefit of its
creditors; or (iii) the commencement against the Company of any case, proceeding
or other action of a nature referred to in clause (i) above which (x) results in
the entry of an order for relief or any such  adjudication or appointment or (y)
remains  undismissed,  undischarged or unbonded for a period of 60 days; or (iv)
the  commencement  against the Company of any case,  proceeding  or other action
seeking  issuance of a warrant of  attachment,  execution,  distraint or similar
process against all or any  substantial  part of its assets which results in the
entry of an  order  for any such  relief  which  shall  not have  been  vacated,
discharged,  or stayed or bonded  pending  appeal within 60 days after the entry
thereof;  or (v) the Company taking any action in furtherance  of, or indicating
its consent to,  approval  of, or  acquiescence  in any of the acts set forth in
clause (i), (ii) (iii) or (iv) above.

                  (f)  Judgments,  writs or warrants of attachment or orders for
the payment of money, singly or in the aggregate,  in excess of $1,000,000 shall
be  rendered  against  the  Company,  and such  judgments,  writs or warrants of
attachment  or orders shall  continue  unsatisfied  and unstayed for a period of
thirty (30) days.

                  (g) Any  security  interest  or lien  granted  herein or to be
granted hereunder in the Security  Agreement and/or the Assignment shall for any
reason cease to be a valid and perfected security interest or lien, subject only
to the Senior Debt.


         10.2.     Remedies

                  Upon the occurrence of any Event of Default, and in every such
event,  the  Investor  may, at its option,  declare the Note to be, and the Note
shall thereupon become, immediately due and payable without presentment, demand,
protest  or other  notice of any kind,  all of which  are  hereby  waived by the
Company,  and exercise all of the rights,  powers and remedies  available  under
this

                                       36

<PAGE>


Purchase Agreement, the Note, the Security Agreement and the Assignment, at  law
or in equity.


11.       THE CLOSING


         11.1.     Closing

                  Subject  to  the  terms  and   conditions   of  this  Purchase
Agreement,  the Closing  shall take place at 10:00 a.m. in  Baltimore,  Maryland
time on January 30, 1997 at the offices of Doctors  Health System,  Inc.,  10451
Mill Run Circle, 10th Floor, Owings Mills, Maryland 21117, or at such other time
as the parties may agree to in writing (the "Closing Date").


         11.2.     Deliveries by the Company to the Investor

                  At the Closing,  the Company shall deliver to the Investor the
following:

                  (a)      the original Note executed by the Company;

                  (b)      executed copies of the Option Agreement, the  Amended
and Restated Stockholders Agreement, and the Amended and  Restated  Registration
Rights Agreement;

                  (c)      a copy of the Restated Articles, as certified by  the
Maryland State Department of Assessments and Taxation;

                  (d) a certified copy of the  resolutions  adopted by the Board
of Directors of the Company  authorizing the  transactions  contemplated by this
Purchase  Agreement or any written  consent of all of the current members of the
Board of Directors of the Company  (effective as of the Closing  Date)  required
for the consummation of the transactions contemplated herein;

                  (e)      the certificates required by Section 8.5 and 8.13(b);

                  (f)      an Advance Request for the Initial Advance;

                  (g)      the opinion required by Section 8.6;

                  (h)      certificates of incumbency and specimen signatures of
the signatory officers of the Company;

                  (i) good standing certificates as of a date not more than five
days  prior  to the  Closing  Date  issued  by the  Secretary  of  State  of the
respective  states

                                       37

<PAGE>


of incorporation  of the Company  and of  each  Subsidiary incorporated  in  the
United  States,  and of each state in which  the  Company  is  qualified  to  do
business;

                  (j)      such  other  Documents as the Investor may reasonably
request.


         11.3.     Deliveries by the Investor to the Company

                  At the Closing, the Investor shall deliver the following:

                  (a)      a  wire transfer to the Company in the amount of  the
Initial Advance;

                  (b)      executed  copies of the Option Agreement, the Amended
and Restated Stockholders Agreement, and the Amended and  Restated  Registration
Rights Agreement; and

                  (c)      such  other  Documents  as the Company may reasonably
request.


12.       SURVIVAL OF REPRESENTATIONS AND COVENANTS; INDEMNIFICATION; REMEDIES;
          TAX MATTERS


         12.1.     Survival of Representations and Covenants

                  All representations,  warranties,  covenants,  indemnities and
other Agreements made by any party to this Purchase Agreement herein or pursuant
hereto  shall also be deemed made on and as of the  Closing  Date as though such
representations,  warranties,  covenants,  indemnities and other Agreements were
made on and as of such date. All  representations  and warranties of the Company
contained in Section 3 and of the  Investor  contained in Sections 4 and 5 shall
survive the Closing Date until 5 p.m.  Baltimore,  Maryland  time on February 1,
2000. Except as otherwise set forth herein, the covenants, indemnities and other
agreements  contained  herein shall  survive the Closing and any  investigation,
audit or inspection at any time made by or on behalf of any party hereto.


         12.2.     Agreement of the Company to Indemnify

                  (a) Subject to the  conditions  and provisions of this Section
12,  the  Company  hereby  agrees to  indemnify,  defend and hold  harmless  the
Investor  Indemnified  Persons  from and  against  and in  respect of all Claims
asserted against,  imposed upon or incurred by the Investor  Indemnified Persons
(whether  such  Claims are by,  against or relate to the  Company,  or any other
party,  including,  without  limitation,  a  governmental  entity),  directly or
indirectly, by

                                       38

<PAGE>


reason   of  or   resulting   from  any  misrepresentation  or  breach   of  any
representation  or  warranty,  or  noncompliance  with   conditions   or   other
Agreements,  given or made by the Company in this  Purchase  Agreement or in the
Disclosure  Schedule or Exhibits attached hereto or in any Document delivered by
or on behalf of any the Company pursuant to this Purchase Agreement.

                  (b)  Except  with  respect  to Claims  based upon fraud by the
Company in connection with the  representations,  warranties or covenants of the
Company  contained  in  this  Purchase  Agreement  or any  of  the  transactions
contemplated  by this  Purchase  Agreement,  or as  otherwise  provided  in this
Purchase   Agreement,   the  Company  shall  not  be  required  to  provide  any
indemnification  under the  provisions of this Section 12.2 unless and until the
aggregate losses of the Investor Indemnified Persons exceed $100,000,  whereupon
the Investor  Indemnified  Persons shall be entitled to indemnification  for the
aggregate  cumulative amount of losses in excess of such $100,000.  In addition,
except with respect to Claims based upon fraud by the Company in connection with
the  representations,  warranties or covenants of the Company  contained in this
Purchase  Agreement or any of the  transactions  contemplated  by this  Purchase
Agreement,  or as otherwise  provided in this  Purchase  Agreement,  the maximum
aggregate amount of indemnification which the Investor Indemnified Parties shall
be entitled to from the Company under this Section 12.2 shall be an amount equal
to the Purchase Price.

                  (c) Except for Claims of, or based upon,  fraud by the Company
in connection with the  representations,  warranties or covenants of the Company
contained in this Purchase Agreement or any of the transactions  contemplated by
this Purchase Agreement,  this Section 12.2 and the related procedures contained
in Section 12.3 hereof shall provide the sole and  exclusive  remedy for any and
all losses with respect to any inaccuracy in or breach of the representations or
warranties  or breach or  nonperformance  of any of the  covenants or agreements
made by any party in or pursuant to this Purchase Agreement.


         12.3.     Conditions of Indemnification

                  The  obligations  and  liabilities  of  the  Company  and  the
Investor hereunder with respect to their respective indemnities pursuant to this
Section 12, resulting from any Claim shall be subject to the following terms and
conditions:

                  (a) The indemnified  party shall give prompt written notice to
the  indemnifying  party of any Claim which is asserted  against,  resulting to,
imposed  upon or incurred by such  indemnified  party and which may give rise to
liability of the indemnifying  party pursuant to this Section 12 stating (to the
extent known or reasonably  anticipated)  the nature and basis of such Claim and
the amount thereof.

                                       39

<PAGE>


                  (b) The  indemnifying  party shall engage counsel with respect
to any such Claim, such  representation  (including the compromise or settlement
of any  Claim) to be  undertaken  on behalf of the  indemnified  party,  and the
indemnified party shall have right to approve such counsel (such approval not to
be unreasonably  withheld).  In the event the  indemnifying  party elects not to
undertake  such defense by its own counsel,  the  indemnifying  party shall give
prompt  written  notice  of such  election  to the  indemnified  party,  and the
indemnified  party  will  undertake  the  defense  thereof  by  counsel or other
representatives  designated  by it, at the cost and expense of the  indemnifying
party  (such  costs  and  expenses  of  such  defense  to  be  advanced  by  the
indemnifying party as incurred by the indemnified party).

                  (c)  In  the  event  that  any  Claim  shall  arise  out  of a
transaction or cover any period or periods wherein the Company, on the one hand,
and the Investor,  on the other hand, shall each be liable hereunder for part of
the liability or obligation  arising  therefrom,  then the parties  shall,  each
choosing its or his own counsel and bearing its or his own expense,  defend such
Claim,  and no  settlement  or  compromise of such Claim may be made without the
joint consent or approval of each party (which consent shall not be unreasonably
withheld),  except  where the  respective  liabilities  and  obligations  of the
parties are clearly allocable or attributable on the basis of objective facts.

                  (d) The  amount  which  any  indemnifying  party  is or may be
required  to pay any  indemnified  party  pursuant  to this  Section 12 shall be
measured  taking into  account  (i) any income tax savings  (and income tax cost
attributable  to the indemnity  payment)  actually  realized (or occurred)  that
affect the overall  economic impact of the losses to the indemnified  party, and
(ii) any insurance proceeds actually realized and adverse insurance consequences
incurred  (such as premium  adjustments  and other  detriments)  that affect the
overall economic impact of the losses to the indemnified party.


         12.4.     Specific Performance

                  In addition to any other  remedies which the Investor may have
at law or in equity,  the Company  hereby  acknowledge  that the Company and the
Subsidiaries  are unique,  and that the harm to the  Investor  resulting  from a
failure  to  close  the  transaction  due  to  breaches  by the  Company  of its
obligations  cannot be  adequately  compensated  by  damages.  Accordingly,  the
Company  agree  that in the event of a failure  to close  the  transaction  as a
result of breaches by the Company, the Investor shall have the right to have all
obligations,  undertakings,  Agreements,  covenants and other provisions of this
Purchase Agreement  specifically performed by the Company, and that the Investor
shall have the right to obtain an order or decree of such  specific  performance
in any of the  courts of the  United  States of America or of any state or other
political subdivision thereof.

                                       40

<PAGE>


13.       TERMINATION


         13.1.     Termination

                  This  Purchase  Agreement may be terminated at any time before
the Closing Date under any one or more of the following circumstances:

                  (a)      by the mutual consent of the parties hereto; or

                  (b)      by the Company or the Investor, by written  notice of
termination  to  the  other  parties  hereto, if the Closing has not occurred by
February 14, 1996.

                  Notwithstanding this Section 13.1, a party who is in breach of
any of its  obligations  or  representations  and  warranties  set forth in this
Purchase  Agreement  shall  not  have  the  right  to  terminate  this  Purchase
Agreement.


         13.2.     Effect of Termination

                  In the event of  termination  of this  Purchase  Agreement  as
provided in Section 13.1, this Purchase  Agreement  shall forthwith  become void
and  have no  effect,  except  that  notwithstanding  anything  to the  contrary
contained  in this  Purchase  Agreement,  no party shall be relieved or released
from any  liabilities  or  damages  arising  out of its  willful  breach  of any
provision of this Purchase  Agreement or any  intentional  misrepresentation  or
breach of warranty hereunder.


14.       MISCELLANEOUS


         14.1.     Additional Actions and Documents

                  Each of the parties  hereto  hereby agrees to take or cause to
be taken such  further  actions,  to  execute,  deliver  and file or cause to be
executed,  delivered  and filed such  further  Documents,  and will  obtain such
consents,  as may be  necessary  or as may be  reasonably  requested in order to
fully effectuate the purposes, terms and conditions of this Purchase Agreement.


         14.2.     No Brokers

                  Each of the  parties  hereto  represents  and  warrants to the
other  parties (and to each of them) that such party has not engaged any broker,
finder  or  agent  in  connection  with the  transactions  contemplated  by this
Purchase  Agreement  and has not  incurred  (and  will  not  incur)  any  unpaid
liability to any broker,  finder or agent for any brokerage fees,  finders' fees
or commissions,  with

                                       41

<PAGE>


respect to the transactions  contemplated by this Purchase Agreement. Each party
agrees to indemnify,  defend and hold harmless each of the  other  parties  from
and against any and all claims asserted  against such parties for any  such fees
or  commissions  by any persons  purporting  to act or to have acted for  or  on
behalf of the indemnifying party.


         14.3.     Expenses

                  Each of the parties hereto shall pay all expenses  incurred by
such party incident to this Purchase Agreement and the transactions contemplated
hereunder, including all legal and accounting fees.


         14.4.     Assignment

                  The  Investor  and GHV shall  have the  right to assign  their
respective rights and obligations under this Purchase Agreement,  in whole or in
part, to an Affiliate  wholly owned by GHV or to designate any of its Affiliates
(to the extent  permitted  by Law) to exercise any of the rights of the Investor
or GHV, as the case may be, or to perform any of their  respective  obligations.
The  Company  shall not assign its rights and  obligations  under this  Purchase
Agreement,  in whole or in  part,  whether  by  operation  of law or  otherwise,
without the prior  written  consent of the other  parties  hereto,  and any such
assignment  contrary to the terms  hereof shall be null and void and of no force
and effect. In no event shall the assignment by the Company, the Investor or GHV
of their respective rights or obligations under this Purchase Agreement, whether
before or after the Closing, release the Company, the Investor or GHV from their
respective liabilities and obligations hereunder.


         14.5.     Entire Agreement; Amendment

                  This Purchase  Agreement,  including the Disclosure  Schedule,
the  Exhibits  and other  Documents  referred  to herein or  delivered  pursuant
hereto,  constitutes the entire  Agreement among the parties hereto with respect
to the  transactions  contemplated  herein,  and it supersedes all prior oral or
written  Agreements,  commitments or understandings  with respect to the matters
provided for herein.  No amendment,  modification  or discharge of this Purchase
Agreement  shall  be valid or  binding  unless  set  forth in  writing  and duly
executed and delivered by the party against whom  enforcement  of the amendment,
modification, or discharge is sought.

                                       42

<PAGE>


         14.6.     Waiver

                  No  delay  or  failure  on the  part of any  party  hereto  in
exercising any right,  power or privilege under this Purchase Agreement or under
any other  Documents  delivered in connection  with or pursuant to this Purchase
Agreement  shall impair any such right,  power or privilege or be construed as a
waiver of any default or any acquiescence therein. No single or partial exercise
of any such right,  power or privilege  shall  preclude the further  exercise of
such right,  power or  privilege,  or the exercise of any other right,  power or
privilege.  No waiver  shall be valid  against any party  hereto  unless made in
writing  and signed by the party  against  whom  enforcement  of such  waiver is
sought and then only to the extent expressly specified therein.


         14.7.     Consent to Jurisdiction

                  (a) This Purchase  Agreement and the duties and obligations of
the Company,  the  Investor,  and GHV  hereunder and under each of the Documents
referred  to  herein  shall  be  enforceable  against  any of the  Company,  the
Investor,  or GHV in the courts of the United States of America and of the State
of  Maryland.  For such  purpose,  the  Company,  the  Investor,  and GHV hereby
irrevocably submit to the non-exclusive  jurisdiction of such courts, and agrees
that all claims in respect of this Purchase  Agreement and such other  Documents
may be heard and determined in any of such courts.

                  (b) The  Company,  the  Investor,  and GHV hereby  irrevocably
agree that a final judgment of any of the courts  specified  above in any action
or  proceeding  relating  to  this  Purchase  Agreement  or to any of the  other
Documents  referred to herein or therein shall be conclusive and may be enforced
in other  jurisdictions  by suit on the judgment or in any other manner provided
by law.


         14.8.     Severability

                  If any part of any provision of this Purchase Agreement or any
other  Agreement  or  document  given  pursuant  to or in  connection  with this
Purchase  Agreement shall be invalid or unenforceable in any respect,  such part
shall be ineffective to the extent of such invalidity or unenforceability  only,
without  in any way  affecting  the  remaining  parts of such  provision  or the
remaining provisions of this Purchase Agreement.


         14.9.     Governing Law

                  This Purchase  Agreement,  the rights and  obligations  of the
parties hereto,  and any claims or disputes relating thereto,  shall be governed
by and

                                       43

<PAGE>


construed  in  accordance  with the laws of the State of Maryland (excluding the
choice of law rules thereof).


         14.10.    Notices

                  All notices, demands,  requests, or other communications which
may be or are  required to be given,  served,  or sent by any party to any other
party pursuant to this Purchase  Agreement shall be in writing and shall be hand
delivered,  sent by overnight  courier or mailed by  first-class,  registered or
certified mail,  return receipt  requested,  postage prepaid,  or transmitted by
telegram, telecopy or telex, addressed as follows:

                  (i)      If to the Investor or GHV:

                           Genesis Holdings, Inc.
                           Genesis Health Ventures, Inc.
                           148 West State Street
                           Kennett Square, Pennsylvania  19348
                           Attention:  George V. Hager and John F. DePodesta
                           Telecopy:  610-444-4483

                  with a copy (which shall not constitute notice) to:

                           Hogan & Hartson L.L.P.
                           555 Thirteenth Street, N.W.
                           Washington, D.C.  20004
                           Attention:  Michael C. Williams
                           Telecopy:  202-637-5910

                  (ii)     If to the Company:

                           Doctors Health System, Inc.
                           10451 Mill Run Road
                           Owings Mills, Maryland  21117
                           Attention:  Paul A. Serini
                           Telecopy:  410-654-5806

Each party may designate by notice in writing a new address to which any notice,
demand,  request or  communication  may thereafter be so given,  served or sent.
Each notice,  demand,  request,  or communication which shall be hand delivered,
sent,  mailed,  telecopied or telexed in the manner  described  above,  or which
shall be delivered to a telegraph company,  shall be deemed  sufficiently given,
served,  sent,  received  or  delivered  for all  purposes at such time as it is
delivered to the addressee (with the return receipt,  the delivery  receipt,  or
(with respect to a telecopy or telex) the  answerback  being deemed  conclusive,
but not  exclusive,

                                       44

<PAGE>


evidence  of  such  delivery)  or  at  such  time  as delivery is refused by the
addressee upon presentation.


         14.11.    Headings

                  Section  headings  contained in this  Purchase  Agreement  are
inserted for convenience of reference only,  shall not be deemed to be a part of
this  Purchase  Agreement  for any  purpose,  and shall not in any way define or
affect the meaning, construction or scope of any of the provisions hereof.


         14.12.    Execution in Counterparts

                  To  facilitate  execution,  this  Purchase  Agreement  may  be
executed in as many  counterparts as may be required.  It shall not be necessary
that the signatures  of, or on behalf of, each party,  or that the signatures of
all persons required to bind any party, appear on each counterpart; but it shall
be sufficient  that the  signature of, or on behalf of, each party,  or that the
signatures of the persons  required to bind any party,  appear on one or more of
the  counterparts.  All  counterparts  shall  collectively  constitute  a single
Agreement.  It shall not be necessary in making proof of this Purchase Agreement
to produce  or account  for more than a number of  counterparts  containing  the
respective signatures of, or on behalf of, all of the parties hereto.


         14.13.    Limitation on Benefits

                  The covenants,  undertakings  and agreements set forth in this
Purchase  Agreement shall be solely for the benefit of, and shall be enforceable
only by, the parties hereto and their respective successors,  heirs,  executors,
administrators,  legal  representatives  and permitted assigns,  except that the
agreements  set  forth in  Section  12 also  shall be for the  benefit  of,  and
enforceable by, Investor  Indemnified  Persons and their respective  successors,
heirs, executors, administrators, legal representatives or permitted assigns.


         14.14.    Binding Effect

                  Subject to any provisions hereof restricting assignment,  this
Purchase  Agreement  shall be binding upon and shall inure to the benefit of the
parties   hereto   and   their   respective   successors,    heirs,   executors,
administrators, legal representatives and assigns.

                                       45

<PAGE>


                  IN WITNESS WHEREOF, the parties hereto have duly executed this
Purchase  Agreement,  or have caused this Purchase Agreement to be duly executed
on their behalf, as of the day and year first above written.

                                    COMPANY

                                    DOCTORS HEALTH SYSTEM, INC.


                                    By:
                                    Name:
                                    Title:


                                    INVESTOR

                                    GENESIS HOLDINGS, INC.


                                    By:
                                    Name:
                                    Title:


                                    GHV

                                    GENESIS HEALTH VENTURES, INC.


                                    By:
                                    Name:
                                    Title:


                                       46

<PAGE>


                                   EXHIBIT A
                           TO NOTE PURCHASE AGREEMENT

                                  DEFINITIONS


                  "Advance"  means  an  advance  of  funds  in  payment  of  the
purchase.

                  "Advance Date" has the meaning set forth in Section 9 hereof.

                  "Affiliate" means: (a) with respect to a person, any member of
such  person's  family;  (b) with respect to an entity,  any officer,  director,
stockholder,  partner or investor of or in such entity or of or in any Affiliate
of such entity; and (c) with respect to a person or entity, any person or entity
which directly or indirectly,  through one or more intermediaries,  Controls, is
Controlled by, or is under common Control with such person or entity.

                  "Agreement"   means  any  concurrence  of  understanding   and
intention  between  two or more  persons  (or  entities)  with  respect to their
relative rights and/or obligations or with respect to a thing done or to be done
(whether or not conditional,  executory, express, implied, in writing or meeting
the requirements of contract), including, without limitation, contracts, leases,
promissory notes, covenants,  easements, rights of way, covenants,  commitments,
arrangements and understandings.

                  "Assets" means assets of every kind and everything  that is or
may be available for the payment of liabilities  (whether inchoate,  tangible or
intangible), including, without limitation, real and personal property.

                  "Assignment"  means the Collateral  Assignment of Rights Under
Physician Services Organization  Agreements,  of even date herewith, made by the
Company  for  the  benefit  of the  Investor,  as may be  amended,  modified  or
supplemented.


                  "Claims"  means all  demands,  claims,  pending or  threatened
actions  or  causes of  action,  suits,  orders,  legal  proceedings,  formal or
informal notice of any complaint,  directive, citation, notice of responsibility
or potential responsibility,  information request, assessments,  losses, damages
(including,  without limitation,  diminution in value),  liabilities,  costs and
expenses, including, without limitation, interest, penalties and attorneys' fees
and disbursements.

                  "Class  B  Common  Stock"  means  the shares of Class B common
stock, $.01 par value per share, of the Company.

<PAGE>

                  "Class  C  Common  Stock" means  the  shares of Class C common
stock, $.01 par value per share, of the Company.

                  "Closing"  means  the  closing of the sale and purchase of the
Note and the funding of the Initial Advance.

                  "Closing Date" has the meaning set forth in Section 11.1.

                  "Code"  means the Internal  Revenue Code of 1986,  as amended,
and all Laws promulgated pursuant thereto or in connection therewith.

                  "Common  Control  Entity"  means any trade or  business  under
common control (as such term is defined in Section 414(b) or 414(c) of the Code)
with the Company or any Subsidiary.

                  "Company"  means  Doctors  Health  System,  Inc.,  a  Maryland
corporation.

                  "Company Tax  Returns"  means all  federal,  state,  local and
other applicable tax returns,  declarations of estimated tax reports required to
be filed by, or which  include,  the Company or any of the  Subsidiaries  or the
Medical  Groups  (without  regard  to  extensions  of time  permitted  by law or
otherwise).

                  "Consolidated" means, with respect to financial statements,  a
consolidation with respect to the reporting of assets, liabilities and operating
accounts of the Company and its international operations.

                  "Conversion Price" has the meaning set forth  in  Section  2.5
hereof.

                  "Control" means possession,  directly or indirectly,  of power
to direct or cause the  direction of  management  or policies  (whether  through
ownership of voting securities, by Agreement or otherwise).

                  "DOL" means the Department of Labor or its successors.

                  "Disclosure Schedule" means the disclosure schedule identified
as the Disclosure Schedule to the Purchase Agreement.

                  "Documents"  means  any  paper or other  material  (including,
without  limitation,  computer  storage media) on which is recorded (by letters,
numbers or other marks)  information that may be evidentially  used,  including,
without limitation, legal opinions,  mortgages,  indentures, notes, instruments,
leases, Agreements,  insurance policies,  reports, studies, financial statements
(including,  without  limitation,  the notes thereto),  other written  financial
information,

                                       2

<PAGE>


schedules,  certificates,  charts,  maps, plans, photographs, letters, memoranda
and all similar materials.

                  "Encumbrance"  means, with respect to any Asset, any mortgage,
lien, pledge,  encumbrance,  security interest,  deed of trust,  order,  decree,
judgment,  charge,  or any  other  type of  arrangement  that has the  effect of
creating a security interest in respect of such Asset.


                  "Environmental   Laws"  means  any  Laws  (including   without
limitation,  the  Comprehensive   Environmental  Response,   Compensation,   and
Liability  Act),  now  or  hereafter  in  effect  relating  to  the  generation,
production,  installation,  use, storage,  treatment,  transportation,  release,
threatened  release, or disposal of Hazardous  Materials,  noise control, or the
protection of human health, safety, natural resources, animal health or welfare,
or the environment.

                  "ERISA" means the Employee  Retirement  Income Security Act of
1974, as amended,  and all Laws  promulgated  pursuant  thereto or in connection
therewith.

                   "ESOP" means an "employee  stock ownership plan" as such term
is defined in Section 407(d)(6) of ERISA or Section 4975(e)(7) of the Code.

                  "Exhibit" means an exhibit attached to the Purchase Agreement.

                  "401(k) Plan" means the 401(k)  employee  benefit plan adopted
by the Company effective January 1, 1996.

                  "Future  Advances" means monthly Advances to the Company after
April 1, 1997 as contemplated in Section 2.2.2 hereof.

                  "GHV"  means  Genesis  Health  Ventures,  Inc., a Pennsylvania
corporation.

                  "GHV  Services"  has  the  meaning  set  forth in Section 3.27
hereof.

                  "Hart-Scott-Rodino"  means  the  Hart-Scott-Rodino   Antitrust
Improvements Act of 1976, as amended,  and all Laws promulgated pursuant thereto
or in connection therewith.


                  "Hazardous Materials" means any wastes, substances, radiation,
or materials (whether solids,  liquids or gases) which are subject to regulation
under any  Environmental  Laws; (iii) the presence of which on the Real Property
cause or threaten to cause a nuisance pursuant to applicable statutory or common
law upon the Real Property or to adjacent  properties;  (iv) without limitation,
which contain  polychlorinated  biphenyls (PCBs),  asbestos,  lead-based paints,
urea-formaldehyde

                                       3

<PAGE>


foam  insulation,   and  petroleum  or  petroleum   products (including, without
limitation, crude oil or any fraction thereof) or (iv) which pose  a  hazard  to
human health, safety, natural resources, industrial hygiene, or the environment,
or an impediment to working conditions.

                  "Individual  Account  Plan"  means  a Plan  that  is or was an
"individual account plan" as such term is defined in Section 3(34) of ERISA.

                  "Initial  Advance"  means  the  initial  Advance  made  to the
Company at the Closing as contemplated in Section 2.2.1 hereof.

                  "Intellectual Property" means all franchises,  patents, patent
qualifications,  trademarks,  service marks, trade names, trade styles,  brands,
private labels, copyrights,  know-how, computer software, industrial designs and
drawings and general intangibles of a like nature, trade secrets,  licenses, and
rights and filings with respect to the foregoing,  and all reissues,  extensions
and renewals thereof.

                  "Investor"   means   Genesis   Holdings,  Inc.,   a   Delaware
corporation and a wholly-owned subsidiary of GHV.

                  "Investor  Indemnified  Persons"  means the  Investor  and its
respective  Affiliates,   employees,   representatives,   agents,  officers  and
directors.

                  "Laws"  means all  federal,  state and local  statutes,  laws,
ordinances,  regulations,  rules, resolutions,  orders,  determinations,  writs,
injunctions,  awards (including,  without limitation, awards of any arbitrator),
judgments and decrees applicable to the specified persons or entities and to the
businesses and Assets thereof (including,  without limitation,  Laws relating to
securities registration and regulation;  the performance of professional medical
services; the provision and administration of insured and self-funded healthcare
benefits;  the  sale,  leasing,   ownership  or  management  of  real  property;
employment  practices,  terms and  conditions,  and wages  and  hours;  building
standards,  land  use and  zoning;  safety,  health  and  fire  prevention;  and
environmental protection, including Environmental Laws).

                  "Material  Assets"   means Assets having an aggregate value in
excess of $250,000.

                  "Maturity  Date"   has  the meaning set forth in Section 2.4.1
hereof.

                  "Medical Groups" means Baltimore  Medical Group,  LLC, Carroll
Medical Group, LLC, and Cumberland Valley Medical Group, LLC.

                                       4

<PAGE>


                  "Multiemployer Plan" means a "multiemployer plan" as such term
is defined in Section 3(37) of ERISA.

                  "Note" has the meaning set forth in Section 2.1 hereof.

                  "Operating  Plan" has  the meaning set forth in Section 3.6(b)
hereof.

                  "Option  Agreement"  means the  Amended  and  Restated  Option
Agreement  dated as of  September  4, 1996  substantially  in the form  attached
hereto as Exhibit D.

                  "Ordinary   Course  of  Business"  means  ordinary  course  of
business consistent with past practices and prudent business operations.

                  "Other  Arrangement"  means  a  benefit  program  or  practice
providing for bonuses,  incentive  compensation,  vacation pay,  severance  pay,
insurance,  restricted stock, stock options,  employee discounts,  company cars,
tuition  reimbursement  or any other perquisite or benefit  (including,  without
limitation,  any fringe  benefit  under  Section 132 of the Code) to  employees,
officers or independent contractors that is not a Plan.

                  "Outstanding  Principal  Amount"  has the meaning set forth in
Section 2.3 hereof.

                  "Pension  Plan" means an "employee  pension  benefit  plan" as
such term is defined in Section 3(2) of ERISA.

                  "Permanent  Financing"   has  the meaning set forth in Section
2.4.1 hereof.

                  "Permits" has the meaning set forth in Section 3.26.2 hereof.

                  "Person"  means any  individual,  partnership,  joint venture,
corporation,  trust,  unincorporated  organization,  government or department or
agency of a government.

                  "Plan" means any plan, program or arrangement,  whether or not
written,  that is or was an "employee  benefit  plan" as such term is defined in
Section  3(3) of  ERISA  and (a)  which  is  maintained  by the  Company  or any
Subsidiary  or Medical  Group;  (b) to which the  Company or any  Subsidiary  or
Medical Group  contributed  or was obligated to contribute or to fund or provide
benefits;  or (c) which provides or promises benefits to any person who performs
or who has performed services for the Company or any Subsidiary or Medical Group
and because of those  services is or has been (i) a participant  therein or (ii)
entitled

                                       5

<PAGE>


to benefits thereunder. The term "Plan" shall not include any plan maintained by
any Person prior to such Person's affiliation with a  Subsidiary  or  a  Medical
Group.

                  "Proposal" means any proposal, offer or indication of interest
from any Person,  entity or group relating to any acquisition or purchase of all
or (other than in the Ordinary Course of Business) any portion of the assets of,
or any equity in, the  Company or any  business  combination  with the  Company,
other than the transactions contemplated by the Purchase Agreement.

                  "Purchase  Agreement"  means  this  Note  Purchase  Agreement,
including the Disclosure Schedule and all Exhibits hereto.

                  "Qualified  Plan" means a Pension Plan that  satisfies,  or is
intended by the  Company to  satisfy,  the  requirements  for tax  qualification
described in Section 401 of the Code.


                  "Real Property" means any real property  currently operated or
leased, or formerly owned, operated, or leased, by the Company, its Subsidiaries
or any Medical Group.


                  "Registration Statement" has the meaning set forth in  Section
3.28 hereof.


                  "Restated  Articles"  means  the  articles  of  amendment  and
restatement of the Company in the form attached hereto as Exhibit F.

                  "Section"   means  a Section (or a subsection) of the Purchase
Agreement.

                  "Securities Act" means the Securities Act of 1933, as amended,
and all laws promulgated pursuant thereto or in connection therewith.

                  "Security  Agreement"  means the Security  Agreement,  of even
date herewith, between the Company and the Investor, as may be amended, modified
or supplemented.

                  "Senior Debt" means certain  indebtedness  of the Company in a
principal amount not to exceed $4,000,000 owing to NationsBank, N.A. pursuant to
that certain Loan Agreement,  dated as of December 1, 1995,  between the Company
and NationsBank, N.A.

                  "Series C Preferred" means the Series C Preferred Stock of the
Company.

                                       6

<PAGE>


                  "Stock Purchase  Agreement" means the Stock Purchase Agreement
dated as of September 4, 1996 between the Company and GHV.

                  "Subsidiary"  means a corporation  or other entity of which at
least 80% of the outstanding securities or other interests having rights to vote
or otherwise exercise Control are held, directly or indirectly, by the Company.

                  "Taxes" means all federal,  state and local taxes  (including,
without  limitation,  income,  profit,  franchise,  sales,  use, real  property,
personal  property,  ad valorem,  excise,  employment,  social security and wage
withholding   taxes)  and   installments   of  estimated   taxes,   assessments,
deficiencies,   levies,  imports,   duties,  license  fees,  registration  fees,
withholdings,  or other similar charges of every kind,  character or description
imposed by any governmental or quasi-governmental authorities, and any interest,
penalties or additions to tax imposed thereon or in connection therewith.

                  "Title  I Plan"  means a Plan  that is  subject  to Title I of
ERISA.

                  "Welfare  Plan" means an "employee  welfare  benefit  plan" as
such term is defined in Section 3(1) of ERISA.

                                       7

<PAGE>

<TABLE>
<CAPTION>
                                TABLE OF CONTENTS
                                                                                                    Page
<S> <C>
1. DEFINITIONS.......................................................................................1
2. SALE AND PURCHASE OF  NOTE........................................................................1
      2.1. Sale and Purchase of Note.................................................................1
      2.2. Purchase Price; Advances..................................................................2
      2.3. Interest..................................................................................2
      2.4. Repayments and Prepayments................................................................3
      2.5. Conversion................................................................................3
3. REPRESENTATIONS AND WARRANTIES OF THE COMPANY.....................................................4
      3.1. Organization and Standing.................................................................4
      3.2. Subsidiaries..............................................................................4
      3.3. Articles of Incorporation and Bylaws......................................................5
      3.4. Capitalization............................................................................5
      3.5. Directors, Officers and Employees.........................................................6
      3.6. Financial Statements......................................................................6
      3.7. No Liabilities............................................................................7
      3.8. Accounts Receivable.......................................................................7
      3.9. Taxes.....................................................................................7
      3.10. Conduct of Business; Absence of Material Adverse Change..................................9
      3.11. Title to Property and Assets.............................................................10
      3.12. Insurance................................................................................10
      3.13. Intellectual Property....................................................................11
      3.14. Debt Instruments.........................................................................11
      3.15. Leases...................................................................................12
      3.16. Other Agreements.........................................................................12
      3.17. Books and Records........................................................................14
      3.18. Litigation; Disputes.....................................................................14
      3.19. Labor Relations..........................................................................14
      3.20. Pension and Benefit Plans................................................................15
      3.21. Environmental............................................................................17
      3.22. Transactions with Related Parties........................................................18
      3.23. Restrictions and Consents................................................................18
      3.24. Authorization............................................................................18
      3.25. Absence of Violations....................................................................19
      3.26. Regulatory Matters.......................................................................19
      3.27. Certain Future Relationships.............................................................22
      3.28. SEC Registration.........................................................................22
      3.29. Binding Obligation.......................................................................22
      3.30. Status of Shares.........................................................................22
      3.31. Offering of Shares.......................................................................23
      3.32. Disclosure...............................................................................23
4. REPRESENTATIONS AND WARRANTIES OF THE INVESTOR....................................................23
<PAGE>
      4.1. Organization and Standing.................................................................23
      4.2. Authorization.............................................................................24
      4.3. Binding Obligation........................................................................24
      4.4. Hart-Scott-Rodino.........................................................................24
      4.5. Certain Future Relationships..............................................................24
5. RESTRICTED SECURITIES.............................................................................24
      5.1. No Registration Under the Securities Act..................................................25
      5.2. Acquisition for Investment................................................................25
      5.3. Evaluation of Merits and Risks of Investment..............................................25
6. ADDITIONAL COVENANTS OF THE COMPANY...............................................................25
      6.1. Reports...................................................................................26
      6.2. Certain Future Relationships..............................................................26
      6.3. Actions Prompting Redemptions.............................................................27
      6.4. Use of Proceeds...........................................................................29
      6.5. Acquisition of Specialist Groups..........................................................29
      6.6. No Material Change to Business Plan.......................................................29
      6.7. Reservation of Shares.....................................................................29
7. CONDITIONS PRECEDENT TO THE COMPANY'S OBLIGATIONS AT THE CLOSING..................................30
      7.1. Representations and Warranties............................................................30
      7.2. Performance...............................................................................30
      7.3. Legal Proceedings.........................................................................30
      7.4. Option Agreement..........................................................................30
      7.5. Amended and Restated Stockholders Agreement...............................................31
      7.6. Amended and Restated Registration Rights Agreement........................................31
      7.7. Documents at Closing......................................................................31
8. CONDITIONS PRECEDENT TO THE INVESTOR'S OBLIGATIONS AT THE CLOSING.................................31
      8.1. Representations and Warranties............................................................31
      8.2. Performance...............................................................................32
      8.3. Absence of Adverse Changes................................................................32
      8.4. Legal Proceedings.........................................................................32
      8.5. Officer's Certificate.....................................................................32
      8.6. Opinion of Counsel........................................................................32
      8.7. Restated Articles.........................................................................32
      8.8. Option Agreement..........................................................................33
      8.9. Amended and Restated Stockholders Agreement...............................................33
      8.10. Amended and Restated Registration Rights Agreement.......................................33
      8.11. Submission of Advance Request............................................................33
      8.12. Documents at Closing.....................................................................33
      8.13. Consents.................................................................................33
9. CONDITIONS PRECEDENT TO THE INVESTOR'S OBLIGATIONS TO MAKE EACH FUTURE ADVANCE....................34
      9.1. Absence of Violations.....................................................................34
<PAGE>
      9.2. Performance...............................................................................34
      9.3. Legal Proceedings.........................................................................34
      9.4. Submission of Advance Request.............................................................35
      9.5. Officer's Certificate.....................................................................35
10. EVENTS OF DEFAULT; REMEDIES......................................................................35
      10.1. Events of Default........................................................................35
      10.2. Remedies.................................................................................36
11. THE CLOSING......................................................................................37
      11.1. Closing..................................................................................37
      11.2. Deliveries by the Company to the Investor................................................37
      11.3. Deliveries by the Investor to the Company................................................38
12. SURVIVAL OF REPRESENTATIONS AND COVENANTS; INDEMNIFICATION; REMEDIES; TAX MATTERS................38
      12.1. Survival of Representations and Covenants................................................38
      12.2. Agreement of the Company to Indemnify....................................................38
      12.3. Conditions of Indemnification............................................................39
      12.4. Specific Performance.....................................................................40
13. TERMINATION......................................................................................41
      13.1. Termination..............................................................................41
      13.2. Effect of Termination....................................................................41
14. MISCELLANEOUS....................................................................................41
      14.1. Additional Actions and Documents.........................................................41
      14.2. No Brokers...............................................................................41
      14.3. Expenses.................................................................................42
      14.4. Assignment...............................................................................42
      14.5. Entire Agreement; Amendment..............................................................42
      14.6. Waiver...................................................................................43
      14.7. Consent to Jurisdiction..................................................................43
      14.8. Severability.............................................................................43
      14.9. Governing Law............................................................................43
      14.10. Notices.................................................................................44
      14.11. Headings................................................................................45
      14.12. Execution in Counterparts...............................................................45
      14.13. Limitation on Benefits..................................................................45
      14.14. Binding Effect..........................................................................45
</TABLE>

Exhibit A                  Definitions
Exhibit B                  Convertible Subordinated Note
Exhibit C                  Advance Request
Exhibit D                  Option Agreement
Exhibit E                  Stockholders Agreement
Exhibit F                  Registration Rights Agreement
Exhibit G                  Form of Opinion of Company
Exhibit H                  Restated Articles







                                                                    EXHIBIT 10.2

                                                                  Execution Copy


                          DOCTORS HEALTH SYSTEM, INC.

                       Convertible Subordinated 11% Note

                              Due January 31, 1999


$5,000,000                                                      January 31, 1997


                  FOR VALUE RECEIVED,  the  undersigned,  Doctors Health System,
Inc., a Maryland corporation (hereinafter called the "Company"), hereby promises
to pay to Genesis  Holdings,  Inc.  (hereinafter  called the  "Holder"),  at its
offices located at 148 West State Street,  Kennett Square,  PA 19348, or at such
other  place as the Holder may from time to time in  writing  designate,  on the
Maturity Date (as defined in the hereinafter described Note Purchase Agreement),
the principal sum of Five Million  Dollars  ($5,000,000),  or so much thereof as
may be advanced or readvanced from time to time and remain outstanding, together
with interest on the  principal  balance  thereof from time to time  outstanding
from the date of each such advance or  readvance  until paid in full at the rate
of eleven per cent  (11%) per annum  (computed  on the basis of a 360-day  year,
30-day month).

                  This Note is the Convertible  Subordinated Note referred to in
that certain Note Purchase Agreement, of even date herewith,  among the Company,
the Holder, and Genesis Health Ventures,  Inc. (the "Note Purchase  Agreement"),
and is  secured  by  the  collateral  described  in (i)  that  certain  Security
Agreement,  of even date  herewith,  between  the  Company  and the Holder  (the
"Security  Agreement"),  and (ii) that certain  Collateral  Assignment of Rights
Under Physicians Services Organization  Agreements,  of even date herewith, made
by the Company for the benefit of the Holder (the  "Assignment").  The Holder is
entitled to the benefits of the Note Purchase Agreement,  the Security Agreement
and the  Assignment  and  reference  is made  thereto for a  description  of the
collateral  and the rights and  remedies of the Holder  thereunder.  Neither the
reference  to the Note  Purchase  Agreement,  the  Security  Agreement or to the
Assignment,  nor any provision thereof,  shall affect or impair the absolute and
unconditional  obligation  of the Company to pay the  principal  amount  hereof,
together with interest  accrued  thereon,  when due. All capitalized  terms used
herein which are not herein defined shall have the meanings  ascribed to them in
the Note Purchase Agreement.

                  The principal of this Note shall be payable in full, in lawful
money of the United States of America and in immediately available funds (unless
converted

                                       1

<PAGE>

as provided herein), without offset, on the Maturity  Date or such earlier  date
as  provided  herein.  Interest  shall be  payable in full on the Maturity Date,
such payment to be made in the form of the  Company's  Series C Preferred Stock,
par value  $14.00 per share  ("Series C  Preferred"),  in the manner  set  forth
in Section 2.3 of the Note Purchase Agreement.

Subordination

                  This Note is  subordinated  and subject in right of payment to
the  payment,  in  accordance  with its terms,  of certain  indebtedness  of the
Company in a principal  amount not to exceed  $4,000,000  owing to  NationsBank,
N.A.  pursuant to that  certain  Loan  Agreement,  dated as of December 1, 1995,
between the Company and NationsBank, N.A. (together with any successor facility,
the "Senior Debt"); provided, however, that nothing herein shall be construed to
impair the  ability of the  Company to pay to the  registered  owner  hereof any
installments of principal or interest owing hereunder so long as there shall not
have occurred and be continuing a default under the Senior Debt.

Conversion

                  The Holder is hereby given the right, on the Maturity Date, to
convert  the  entire  unpaid  principal  amount of this Note into fully paid and
nonassessable  shares of the Series C  Preferred,  at the price and on the terms
and  conditions  set  forth in the Note  Purchase  Agreement.  The  right of the
Company to make payments on the  principal  amount of this Note shall be subject
at all  times to the  right of the  Holder to  convert  this Note into  Series C
Preferred as provided  herein.  The Company  shall at all times reserve and keep
available a number of its authorized  but unissued  shares of Series C Preferred
sufficient to permit the exercise in full by the Holder of its conversion rights
hereunder.

Default

                  In case an Event of Default (as  defined in the Note  Purchase
Agreement)  shall occur and be  continuing,  this Note may be  declared  due and
payable  in the  manner  and  with the  effect  provided  in the  Note  Purchase
Agreement.

Miscellaneous

                  Upon receipt by the Company of evidence  satisfactory to it of
the loss,  theft,  destruction or mutilation of this Note, and (in case of loss,
theft or destruction) of indemnity satisfactory to it, and upon reimbursement to
the Company of all reasonable expenses  incidental  thereto,  and upon surrender
and cancellation of this Note, if mutilated, the Company will make and deliver a
new

                                       2

<PAGE>

Note of like tenor in the principal amount of this Note then outstanding in lieu
of this Note. Any Note so made and delivered  shall be dated as of the  date  to
which interest shall have been paid on this Note.

                  The terms of this Note shall be governed by and  construed  in
accordance  with the laws of Maryland (but not including the choice of law rules
thereof).

                  This Note  shall not be valid or  obligatory  for any  purpose
until authenticated by the execution hereof by the President or a Vice President
of the Company.

                  IN WITNESS  WHEREOF,  Doctors Health System,  Inc., a Maryland
corporation,  has  caused  this Note to be signed in its  corporate  name by its
President or a Vice  President,  by authority duly given,  all as of the day and
year first above written.

                                         DOCTORS HEALTH SYSTEM, INC.


                                         By:   /s/ Stewart B. Gold
                                             ____________________________
                                         Print Name:   Stewart B. Gold
                                         Title:  President





                                                                    EXHIBIT 10.3



                     AMENDED AND RESTATED OPTION AGREEMENT

                                    between

                          DOCTORS HEALTH SYSTEM, INC.

                                      and

                         GENESIS HEALTH VENTURES, INC.

                          dated as of January 31, 1997



<PAGE>




                     AMENDED AND RESTATED OPTION AGREEMENT


         THIS AMENDED AND RESTATED OPTION AGREEMENT is entered into as of
January 31, 1997, by and between Doctors Health System, Inc., a Maryland
corporation (the "Company"), and Genesis Health Ventures, Inc., a Pennsylvania
corporation ("Genesis").

         WHEREAS, the Company and Genesis entered into a Stock Purchase
Agreement dated September 4, 1996 (the "Stock Purchase Agreement") pursuant to
which Genesis purchased 571,428 shares of the Company's Series C Preferred
Stock, par value $17.50 per share (the "Series C Preferred Stock"); and

         WHEREAS,  the Company and Genesis  Holdings have a wholly-owned
subsidiary of Genesis ("Holdings") have entered into a Note Purchase Agreement
(the "Note Purchase Agreement") and the Company has executed and delivered the
Convertible Subordinated Note of even date herewith pursuant to which Holdings
will provide the Company a $5 million loan facility; and

         WHEREAS, the parties desire to enter into this Amended and Restated
Option Agreement in connection with the purchase by Genesis of additional shares
of Series C Preferred Stock.

         NOW, THEREFORE, in consideration of the foregoing, and the mutual
covenants and agreements hereinafter set forth, the parties hereby agree as
follows:

1.       OPTION TO PURCHASE SHARES

         Subject to the terms and conditions hereof, the Company hereby grants
to Genesis an option (the "Option") to purchase 250,000 shares (as adjusted
herein, the "Shares") of the Series C Preferred Stock. The exercise price of the
Option shall be $20.00 per share, payable by wire transfer in United States
Dollars (the "Option Price"), for a total consideration of $5,000,000. The
Option shall be immediately exercisable by Genesis at any time prior to its
expiration. The Option shall expire upon the earliest date on which one of the
following occurs (the "Option Termination Date"): (i) January 31, 2002; (ii) the
consummation of (a) a Qualified Public Offering, (b) a merger or similar
combination transaction of which the Company is not the survivor, or (c) a sale
or other disposition of substantially

                                       2

<PAGE>

all of the Company's assets (any of (a)-(c) hereinafter referred to as a
"Qualified Transaction"); or (iii) consummation of the Permanent Financing as
defined in the Note Purchase Agreement dated January 31, 1997 by and among the
Company , Genesis and Genesis Holdings, Inc. (the "Note Purchase Agreement). The
Company shall provide Genesis with a written notice at least 30 days prior to
the consummation of any Qualified Transaction. For purposes of this Agreement, a
Qualified Public Offering shall mean an offering of the Company's Common Stock
registered under the Securities Act with (a) the net proceeds to the Company of
the sale of such Common Stock to equal or exceed $25,000,000, (b) a total market
capitalization of the Company at the time of such offering of at least
$100,000,000, (c) the net price per share to equal or exceed the weighted
average price paid by Genesis for each share of Series C Preferred Stock
outstanding immediately prior to such offering, plus all accrued but unpaid
dividends (whether declared or undeclared)  and  interest  thereon,  as
adjusted  for  stock  splits, recapitalizations and similar transactions, and
(d) subject to a firm commitment underwriting  conducted by a nationally
recognized underwriter reasonably acceptable to Genesis.


2.       ADJUSTMENT IN NUMBER OF OPTION SHARES AND/OR OPTION PRICE

         2.01. If the number of outstanding shares of Series C Preferred Stock
is increased or decreased or changed into or exchanged for a different number or
kind of stock or other  securities  of the  Company by reason of any
recapitalization, reclassification (including any reclassification in connection
with a merger, consolidation or other business combination involving the
Company), stock split, reverse split, combination of shares of Series C
Preferred Stock, stock dividend or other distribution payable in capital stock,
or other increase or decrease in shares of Series C Preferred Stock effected
without receipt of consideration by the Company occurring after the date hereof,
a proportionate and appropriate adjustment shall be made by the Company in the
number and kind of shares subject to the Option, so that the proportionate
interest in the Company of Genesis immediately following such event shall, to
the extent practicable, be the same as immediately prior to such event. Any such
adjustment in the Option shall not change the aggregate Option Price with
respect to shares subject to the unexercised portion of the Option but shall
include a corresponding proportionate adjustment in the Option Price per share.

         2.02. If, after the date hereof but prior to the Option Termination
Date (the "Adjustment Period"), the Company sells Series C Preferred Stock or
securities convertible into or exchangeable for Series C Preferred Stock, for a
price (the

                                       3

<PAGE>

"Lower Offering Price") less than the weighted average price paid or to be paid
by Genesis for each share of Series C Preferred Stock then outstanding or
subject to the Option, plus all accrued but unpaid dividends and interest
thereon (the "Weighted Average Price"), the Option Price shall be adjusted to a
price equal to the quotient obtained by dividing:

                  (1) an amount equal to (x) the sum of (A) the total number of
         shares of Series C Preferred  Stock outstanding immediately prior to
         such issuance or sale, plus (B) the total number of shares of Series C
         Preferred Stock issuable upon exercise of all options, warrants and
         other rights convertible or exchangeable for, or evidencing the right
         to purchase shares of Series C Preferred Stock outstanding immediately
         prior to such issuance or sale, if any, multiplied by (C) the Weighted
         Average Price in effect immediately prior to such issuance or sale,
         plus (y) the consideration, if any received or deemed to be received by
         the Company upon such issuance or sale; by

                  (2) the sum of (A) the total number of shares of Series C
         Preferred Stock outstanding immediately after such issuance or sale,
         plus (B) the total number of shares of Series C Preferred Stock
         issuable upon exercise of all options, warrants and other rights
         convertible or exchangeable for, or evidencing the right to purchase
         shares of Series C Preferred Stock outstanding immediately after such
         issuance or sale, if any.

         If, subsequent to such an adjustment, the Company issues or sells
additional shares of Series C Preferred Stock during the Adjustment Period, for
a price of less than the then applicable Weighted Average Price (as adjusted for
all prior adjustments), a further adjustment in the Option Price shall be made
in accordance with this Section 2.


3.       PARTIAL EXERCISE

         The Option shall be exercisable in whole or in part, at any time and
from time to time, after becoming exercisable and prior to termination of the
Option, provided, that no single exercise of the Option shall be for less than
10,000 Shares unless the number of Shares purchased is the total number at the
time available for purchase under this Option. In no event may the Option be
exercised for a fractional Share. The number of shares which may be purchased
upon exercise of the Option shall be reduced by the number of shares previously
purchased upon exercise of the Option.

                                       4

<PAGE>

4.       METHOD OF EXERCISE OF OPTION

         Subject to the terms and conditions of this Option Agreement, Genesis
may exercise the Option with respect to all or any part of the Shares then
subject to such Option by giving the Company written notice of exercise,
specifying the number of Shares as to which the Option is being exercised. Such
notice shall be addressed to the Secretary of the Company at the Company's
principal office, and shall be effective upon delivery (by personal delivery,
fax or other delivery) to the Secretary of the Company. Such notice shall be
accompanied by cash (in U.S. Dollars) in an amount equal to the Option Price of
such Shares. The Company's obligations to issue Shares pursuant to this
Agreement are subject to the expiration, prior to an exercise of the Option, of
any waiting period applicable to the investment by Genesis in the Company
required by the Hart-Scott-Rodino Antitrust Improvements Act of 1976, as
amended.

5.       MANDATORY EXERCISE

         5.01. Mandatory Exercise. Subject to the conditions set forth in
Sections 5.03 and 5.04, the Company may require Genesis to exercise the Option
with respect to such number of Shares as the Company shall determine in an
amount no greater than the number of Shares for which the Option may be
exercised at the end of any month which is the second consecutive month during
which the Company has received payment for a total of at least 20,000 Capitated
Medicare Lives. The Company's right to require a mandatory exercise of the
option shall terminate upon the closing of the Permanent Financing as defined in
the Note Purchase Agreement.

         5.02. The obligations of Genesis to exercise the Option pursuant to
this Section 5 are subject to the fulfillment on or before each such exercise of
each of the following conditions:

                  5.02(a) The Company shall deliver a certificate in the form
         attached as Exhibit A hereto dated as of the date of such exercise.

                  5.02(b) The Company shall have performed and complied with all
         material agreements, obligations and conditions contained in the Stock
         Purchase Agreement and the Restated Stockholders Agreement dated as of
         the date hereof.

                  5.02(c) All consents, authorizations, approvals or permits, if
         any, of any governmental authority or regulatory body of the United
         States or of any state or of any third party that are necessary in
         connection with the exercise of the Option and the lawful issuance of
         the Shares to Genesis

                                       5

<PAGE>

         pursuant to this Option Agreement shall have been duly obtained and
         shall be effective on and as of such exercise other than those which
         are not required to be obtained before such exercise.

                  5.02(d) There shall not have been any default or breach by the
         Company (that has not been cured or waived) with respect to its
         obligations (i) to holders of the Company's Series A Preferred Stock,
         Series B Preferred Stock and Series C Preferred Stock under the
         Company's articles of incorporation, (ii) to NationsBank, N.A. under
         the Loan Agreement dated as of December 1, 1995 and (iii) under any
         credit facility, including, without limitation, the facility currently
         being negotiated with First National Bank of Maryland, N.A.

                  5.02(e) The expiration of any waiting period applicable to the
         investment by Genesis in the Company required by the Hart-Scott-Rodino
         Antitrust Improvements Act of 1976, as amended.

         5.03 The Company shall provide Genesis with a written notice at least
30 days prior to a mandatory exercise pursuant to this Section 5. Such notice
shall set forth the number of Shares for which Genesis will be required to
exercise the Option, which number will not be less than 10,000 Shares.

         5.04. For purposes of this Section 5, the term "Capitated Medicare
Lives" shall mean those Medicare-eligible persons living in Maryland, Delaware,
West Virginia and the District of Columbia and in the areas of Northern Virginia
and Southern Pennsylvania who, at the time of any calculation under this Section
5, are enrolled in (a) a "Medicare HMO" or similar Medicare managed care product
offered directly by the Company under contract with the United States Health
Care Financing Administration ("HCFA") and with respect to whom the Company
receives a capitation or other risk-based payment from HCFA, or (b) a "Medicare
HMO" or other similar Medicare managed care product offered by a health
maintenance organization or other payor with respect to which the Company agrees
to provide or arrange to provide all or substantially all of those services now
qualifying as "Medicare  Part A" and "Medicare  Part B" benefits under
arrangements that permit the Company to realize all or the preponderance of any
savings obtained by managing the provision of such services to enrolled Medicare
members.


6.       LIMITATIONS ON TRANSFER

         The Option is not transferable by Genesis,  other than to a corporation
that, directly or indirectly, is wholly owned by Genesis, and shall not be
pledged or

                                       6

<PAGE>

hypothecated (by operation of law or otherwise) or subject to execution,
attachment or similar processes.

7.       RESERVATION OF STOCK

         The Company shall at all times reserve and keep available, solely for
issuance and delivery upon exercise of the Option, the number of shares of
Series C Preferred Stock from time to time issuable upon exercise of the Option.
All shares of Series C Preferred Stock issuable upon exercise of the Option
shall be duly authorized and, when issued upon exercise and the payment of the
Option Price as provided herein, shall be validly issued, fully paid and
nonassessable with no liability on the part of Genesis.

8.       RIGHTS AS SHAREHOLDER

         Neither Genesis nor any successor or permitted assign shall be, or have
any of the rights or privileges of, a shareholder of the Company in respect of
any Shares issuable hereunder unless and until such Shares have been fully paid
and certificates representing such Shares have been endorsed, transferred and
delivered, and the name of Genesis (or of such successor or permitted assign)
has been entered as the shareholder of record on the books of the Company.

9.       REORGANIZATIONS

         9.1  Reorganization in Which the Company Is the Surviving Entity.
Subject to Section 9.2, if the Company shall be the surviving entity in any
reorganization, merger or consolidation of the Company with one or more other
entities, the Option shall pertain to and apply to the securities to which a
holder of the number of Shares subject to the Option would have been entitled
immediately following such reorganization, merger or consolidation, with a
corresponding proportionate adjustment of the Option Price per share so that the
aggregate Option Price thereafter shall be the same as the aggregate Option
Price of the Shares remaining subject to the Option immediately prior to such
reorganization, merger or consolidation.

         9.2  Reorganization  in Which the Company Is Not the Surviving
Corporation or Sale of Assets. Upon the dissolution or liquidation of the
Company, or upon a merger, consolidation or reorganization of the Company with
one or more other entities in which the Company is not the surviving entity, or
upon a sale of all or substantially all of the assets of the Company to another
entity, or upon any transaction (including, without limitation, a merger or
reorganization in which the Company is the surviving entity) approved by the
Board of Directors of the Company which results in any person or entity, or

                                       7

<PAGE>

persons or entities acting as a group or otherwise in concert owning 50 percent
or more of the combined voting power of all classes of stock of the Company, the
Option hereunder shall terminate, except to the extent provision is made in
writing in connection with such transaction for the continuation and/or the
assumption of the Option, or for the substitution for the Option of new options
covering the stock of a successor corporation, or a parent or subsidiary
thereof, with appropriate adjustments as to the number and kinds of shares of
stock and exercise prices, in which event the Option shall continue in the
manner and under the terms so provided. The Company shall send written notice of
an event that will result in such a termination to Genesis not later than the
time at which the Company gives notice thereof to its shareholders but in no
event less than 30 days prior to such event.

10.      ADJUSTMENTS

         No fractional shares or units of other securities shall be issued
pursuant to any such adjustment, and any fractions resulting from any such
adjustment shall be eliminated in each case by rounding downward to the nearest
whole share or unit. Any disputes regarding adjustments in the Option Price or
number of Shares issuable upon exercise of the Option (including without
limitation any adjustments pursuant to Section 2 hereof) shall be resolved by an
independent arbitrator selected by the Company and Genesis.

11.      MISCELLANEOUS PROVISIONS.

         11.1 Notices. All notices, demands, requests, or other communications
which may be or are required to be given, served, or sent by any party to any
other party pursuant to this Agreement shall be in writing and shall be faxed
and mailed by first-class, registered or certified mail, return receipt
requested, postage prepaid, or transmitted by hand delivery, overnight or
express mail, addresses as follows:

         (i)      If to the Company:

                                    Doctors Health System, Inc.
                                    10451 Mill Run Circle
                                    10th Floor
                                    Owings Mills, Maryland 21117
                                    Attention: Paul A. Serini
                                    Facsimile No.: (410) 654-5806


         (ii)     If to Genesis:

                                       8

<PAGE>


                                    Genesis Health Ventures, Inc.
                                    148 West State Street
                                    Kennett Square, Pennsylvania  19348
                                    Attention: John F. DePodesta
                                    Facsimile No.: (610) 444-7483

         with a copy to:
                                    Hogan & Hartson L.L.P.
                                    555 Thirteenth Street, N.W.
                                    Washington, D.C.  20004
                                    Attention:  Michael C. Williams
                                    Facsimile No.: (202) 637-5910

         Each party may designate by notice in writing a new address to which
any notice, demand, request or communication may thereafter be so given, served
or sent. Each notice, demand, request or communication which shall be mailed,
delivered or transmitted in the manner described above shall be deemed
sufficiently given, served, sent or received for all purposes at such time as it
is delivered to the addressee (with the return receipt, the delivery receipt, or
affidavit of messenger being deemed conclusive evidence of such delivery) or at
such time as delivery is refused by the addressee upon presentation.

         11.2  Entire Agreement;  Modification;  Benefit.  This  Agreement
constitutes the entire agreement of the parties hereto with respect to the
matters contemplated herein, supersede all prior oral and written memoranda and
agreements with respect to the matters contemplated herein, and may not be
modified, deleted or amended except by written instrument executed by the
parties. All provisions of this Agreement shall be binding upon, and shall inure
to the benefit of and be enforceable by, the parties hereto and their respective
successors and permitted assigns.

         11.3 Governing Law. This  Agreement, the rights and obligations of the
parties hereto, and any claims or disputes relating thereto shall be governed by
and construed in accordance with the laws of Maryland (but not including the
choice of law rules thereof).

         11.4 Execution. To facilitate execution, this Agreement may be executed
in as many counterparts as may be required; and it shall not be necessary that
the signatures of, or on behalf of, each party, or the signatures of all persons
required

                                       9

<PAGE>

to bind any party, appear on each counterpart; but it shall be sufficient that
the signature of, or on behalf of, each party, or the signatures of the persons
required to bind any party, appear on one or more of the counterparts. All
counterparts shall collectively constitute a single agreement.


                       [Signatures commence on next page]

                                       10

<PAGE>

                         IN WITNESS WHEREOF, the undersigned have duly executed
this  Agreement,  or have caused this Agreement to be duly executed on their
behalf, as of the date first written above.


                                     DOCTORS HEALTH SYSTEM, INC.



                                     By:
                                        _______________________________
                                            Stewart B. Gold, President


                                     GENESIS HEALTH VENTURES, INC.


                                     By:
                                        _______________________________

                                       11

<PAGE>


                                   Exhibit A

                          DOCTORS HEALTH SYSTEM, INC.
                                  CERTIFICATE


         Doctors Health System, Inc., a Maryland corporation (the "Company"), in
connection with the Amended and Restated Option  Agreement (the "Option
Agreement") dated as of January ___, 1997 between the Company and Genesis Health
Ventures, Inc., a Pennsylvania corporation ("Genesis"), hereby represents and
warrants as of the date hereof (which representations and warranties shall be
deemed to include the disclosures with respect thereto so specified in the
schedules attached hereto) to the Investor as follows, with capitalized terms
used herein without definition having the meanings assigned to them in the Stock
Purchase Agreement dated as of September 4, 1996 between the Company and
Genesis:

         1. Organization and Standing. The Company is a corporation duly
organized, validly existing and in good standing under the laws of the State of
Maryland, and has the full and unrestricted corporate power and authority to
own, operate and lease its Assets, to carry on its business as currently
conducted, to execute and deliver the Option Agreement and to carry out the
transactions contemplated hereby. There is no state, country or territory
wherein the absence of licensing or qualification as a foreign corporation would
have a material adverse effect upon the business of the Company as currently
conducted.

         2. Capitalization.  The authorized capital stock of the Company and the
outstanding shares of capital stock of the Company as of the date hereof will be
as set forth in Schedule 2 hereto. All of such outstanding shares have been
validly issued and are fully paid and nonassessable. No shares of capital stock
of the Company or any Subsidiary have been reserved for any purpose, other than
issuance of capital stock in amounts set forth in Schedule 2 (i) pursuant to the
Company's Omnibus Stock Option Plan , (ii) upon the conversion of Series A
Preferred Stock and the Series B Preferred Stock, (iii) upon the exercise of the
Common Stock Warrants (as defined in Schedule 2) and (iv) pursuant to the Option
Agreement. Except as set forth in Schedule 2, there are no outstanding
securities convertible into or exchangeable for the capital stock of the Company
or any of the Subsidiaries and no outstanding options, rights (preemptive or
otherwise), or warrants to purchase or to subscribe for any shares of such stock
or other securities of the Company or any of the Subsidiaries.

                                       1

<PAGE>


         3. Restrictions and Consents. There are no Agreements, Laws or other
restrictions of any kind to which the Company, any Subsidiary or any Medical
Group (or any asset thereof) is party or subject that would prevent or restrict
the execution, delivery or performance of the Option Agreement or result in any
penalty,  forfeiture,  Agreement termination,  or restriction on business
operations of the Investor, the Company, any Subsidiary or any Medical Group as
a result of the execution, delivery or performance of the Option Agreement.
Schedule 3 lists all such Agreements and Laws that reasonably could be
interpreted or expected to require the consent or acquiescence of any person or
entity not party to the Option Agreement with respect to any aspect of the
execution, delivery or performance of the Option Agreement by the Company, any
Subsidiary or any Medical Group.

         4. Authorization. The execution, delivery and performance by the
Company of the Option Agreement, the fulfillment of and compliance with the
terms and provisions thereof, and the consummation by the Company of the
transactions contemplated thereby, do not and will not: (a) require any consent
or approval of the stockholders of the Company that has not been obtained; (b)
conflict with, or violate any provision of, any Law having applicability to the
Company, any Subsidiary or any Medical Group or any of their respective Assets,
or any provision of the certificate or articles of organization or bylaws or
equivalent constituent document of the Company, any Subsidiary or any Medical
Group; (c) conflict with, or result in any breach of, or constitute a default
under any Agreement to which the Company, any Subsidiary or any Medical Group is
a party or by which it or any of its Assets may be bound; or (d) result in or
require the creation or imposition of or result in the acceleration of any
indebtedness, or of a material Encumbrance, or with respect to, the Company, any
Subsidiary or any Medical Group or any of the Assets now owned or hereafter
acquired by the Company, any Subsidiary or any Medical Group.

         5. Regulatory Matters. The Company and the Subsidiaries and, to the
Company's knowledge, the Medical Groups and the physicians employed by the
Medical Groups have not knowingly or willfully failed to comply with the
regulatory matters described in this Section 5. Schedule 5 contains a list of
exceptions and disclosures that qualify the matters set forth in this Section 5,
where applicable.

                  5.1.  General  Compliance  with Law. The  Company,  the
Subsidiaries and, to the Company's knowledge, the Medical Groups have complied
and are in full compliance with all Laws except where a failure to comply,
singly or in the aggregate, would not have a material adverse effect on the
Company, the Subsidiaries and the Medical Groups, taken as a whole.

                                       2

<PAGE>


                  5.2. Licenses and Permits. The Company, the Subsidiaries, the
Medical Groups and each of the physicians employed by such Persons have all
Permits any federal, state, local, foreign or other governmental agency,
instrumentality, commission, authority, board or any other Person, necessary to
conduct their business as now being conducted except where the failure to have
any such Permit does not have a material adverse effect on the Company, the
Subsidiaries and the Medical Groups, taken as a whole. All Permits of the
Company and the Subsidiaries and, to the Company's knowledge, the Medical Groups
and each of the physicians employed by such Medical Groups are valid and in full
force and effect except where the failure to have any such Permit does not have
a material adverse effect on the Company, the Subsidiaries and the Medical
Groups, taken as a whole. No notice to, declaration, filing or registration
with, or Permit or consent from, any governmental or regulatory body or
authority, or any other Person or entity, is required to be made or obtained by
the Company or any of the Subsidiaries or Medical Groups in connection with the
execution,  delivery or performance of this Purchase  Agreement and the
consummation of the transactions contemplated hereby. Notwithstanding the
foregoing, the Company is not required to obtain any Permit to do business as a
health maintenance organization, insurance company, or other risk-bearing health
care entity under the Laws and regulations of Maryland or the Laws and
regulations of any other jurisdiction in which the Company, the Subsidiaries or
the Medical Groups do business.

                  5.3. Fraud and Abuse Matters. To the Company's knowledge,  the
Company, the Medical Groups, and all persons and entities providing services for
the Company or the Medical Groups, have not engaged in any activities which are
prohibited or could form the basis for criminal penalties, civil monetary
penalties or a mandatory or permissive exclusion from the Medicare, Medicaid or
other federal and state health care programs under ss. ss. 1320a-7, 1320a-7a,
1320a-7b, or 1395nn of Title 42 of the United States Code, the federal CHAMPUS
statute, or any regulations promulgated thereunder, or similar or related
federal, state and local statutes, common law or regulations. Without in any way
limiting the foregoing, the Company, the Medical Groups, and, to the knowledge
of the Company, all persons and entities providing services for the Company or
the Medical Groups have not engaged in any of the following activities:

                           (i)      knowingly and willingly made or caused to be
         made any false statement or representation of a material fact in any
         application for any benefit or payment;

                                       3

<PAGE>


                           (ii)     knowingly and willingly made or caused to be
         made any false statement or representation of a material fact for
         use in determining rights to any benefit or payment;

                           (iii)  presenting or causing to be presented a claim
         for reimbursement under CHAMPUS, Medicare, Medicaid, or other state
         healthcare program that is for an item or service that the person
         presenting or causing to be presented knows or should know was not
         provided as claimed, or presenting a claim that the person presenting
         knows or should know is false or fraudulent;

                           (iv) having knowledge of the occurrence of any event
         affecting (a) his/her initial or continued right to any benefit or
         payment or (b) the initial or continued right to any benefit or payment
         of any other individual in whose behalf he/she has applied for or is
         receiving such benefit or payment, conceals or fails to disclose such
         event with an intent fraudulently to secure such benefit or payment
         either in a greater amount or quantity that is due or when no such
         benefit or payment is authorized;

                           (v)  offering, paying, soliciting or receiving any
         remuneration (including any kickback, bribe, or rebate), directly or
         indirectly, overtly or covertly, in cash or in kind (a) in return for
         referring, or to induce the referral of, an individual to a person for
         the  furnishing or arranging for the furnishing of any item or service
         for which payment may be made in whole or in part by CHAMPUS,  Medicare
         or Medicaid, or other state health care program, or (b) in return for,
         or to induce, the purchase, lease, or order of, or arranging for or
         recommending the purchase, lease, or order of, any good, facility,
         service, or item for which payment may be made in whole or in part by
         CHAMPUS, Medicare or Medicaid, or other state health care program;

                           (vi)  making or causing to be made or inducing  or
         seeking to induce the making of any false statement or representation
         (or omitting to state a fact required to be stated therein or necessary
         to make the statements contained therein not misleading) of a material
         fact with respect to (a) the conditions or operations of a facility in
         order that the facility may qualify for CHAMPUS, Medicare, Medicaid or
         other state health care program certification, or (b) information
         required to be provided under ss. 1124A of the Social Security Act (42
         U.S.C. ss. 1320a-3);

                           (vii)  submitting or causing to be submitted bills or
         requests for payment under Medicare, Medicaid or other state health
         care program containing charges substantially in excess of usual
         charges; or

                                       4

<PAGE>


                           (viii) furnishing or causing to be furnished items or
         services to patients substantially in excess of the needs of such
         patients.

                  5.4.   Health Care Entity. The Company is not a "health care
entity" which provides "designated health services" for purposes of federal
Medicare/Medicaid physician self-referral and anti-kickback laws and regulations
and similar Maryland Laws and regulations.

         6.    Binding Obligation. The Option Agreement constitutes a valid and
binding obligation of the Company, enforceable in accordance with its terms.

         7. Offering of Shares. Neither the Company nor any Person acting on its
behalf has offered the Series C Preferred or any similar securities of the
Company for sale to, solicited any offers to buy the Series C Preferred or any
similar securities of the Company from or otherwise approached or negotiated
with respect to the Company with any Person other than the Investor and a
limited number of other "Accredited Investors" (as defined in Rule 501(a) under
the Securities Act). Neither the Company nor any other Person acting on its
behalf has taken or will take any action prior to the exercise (including,
without limitation, any offering of any securities of the Company under
circumstances which would require the integration of such offering with the
offering of the Series C Preferred under the Securities Act and the rules and
regulations of the Commission thereunder) which might subject the offering,
issuance and sale of the Series C Preferred to the registration requirements of
Section 5 of the Securities Act.

         8. Disclosure. No representation or warranty by the Company herein
contains or will contain any untrue or misleading statement of material fact or
omits or will omit any fact necessary to make the statements of material fact
contained herein or therein, in light of the circumstances under which made, not
misleading.

                                       5

<PAGE>


       IN WITNESS WHEREOF, the undersigned has signed this Certificate on
behalf of Doctors Health System, Inc. this ___ day of _______________.


                                     DOCTORS HEALTH SYSTEM, INC.


                                     By:
                                        ____________________________
                                     Name:
                                     Title:

                                       6

<PAGE>

                             OFFICER'S CERTIFICATE
                         GENESIS HEALTH VENTURES, INC.


         The undersigned, John F. DePodesta, Senior Vice President of Genesis
Health Ventures, Inc., a Pennsylvania corporation (the "Investor"), pursuant to
Stock Purchase Agreement between the Investor and Doctors Health System, Inc.
dated September 4, 1996 (the "Purchase Agreement") and the Amended and Restated
Option Agreement between the Investor and Doctors Health System, Inc. dated
January ___, 1997 (the "Option Agreement"), hereby certifies on behalf of the
Investor as follows:

         1.    The representations and warranties made by the Investor in the
Purchase Agreement are true and correct in all material respects as of the date
hereof.

         2. The Investor has performed and complied with all agreements and
conditions required by the Purchase Agreement to be performed or complied with
by it prior to the date hereof.

         3. No action or proceeding by or before any governmental authority has
been instituted or threatened (and not subsequently dismissed, settled or
otherwise terminated) which is reasonably expected to restrain, prohibit or
invalidate the transactions contemplated by the Purchase Agreement.

         4. Attached as Exhibit I hereto is a true and correct copy of the
resolutions duly adopted by the Board of Directors of the Investor at a meeting
held on August 21, 1996 and such resolutions are in full force and effect on the
date hereof, have not been amended, altered or repealed, and are the only
resolutions by the Board of Directors of the Investor.

                                       1
<PAGE>


           IN WITNESS WHEREOF, the undersigned has executed this Officer's
Certificate as of January ___, 1997.



                                         ______________________________
                                         John F. DePodesta
                                         Senior Vice President


         The undersigned,  _______________________________ of the Investor,
hereby certifies that John F. DePodesta is, on and as of the date hereof, a duly
elected, qualified and acting Senior Vice President of the Investor and the
signature set forth above is his genuine signature.


         Dated:            _____________________________

                                       2










                                                                    EXHIBIT 10.4


                     ARTICLES OF AMENDMENT AND RESTATEMENT

                                       OF

                          DOCTORS HEALTH SYSTEM, INC.


                        Doctors Health System,  Inc., a Maryland  corporation
(the  "Corporation"),  hereby certifies to the State Department of Assessments
and Taxation of Maryland as follows:

            FIRST:  The Corporation  desires to amend and restate its charter in
its entirety by striking out Articles  FIRST through  SEVENTH of the Articles of
Incorporation and by substituting in lieu thereof the following:

                                   ARTICLE I
                                      NAME

                        The name of the corporation (which is hereinafter called
the "Corporation") is:  "DOCTORS HEALTH SYSTEM, INC."

                                   ARTICLE II
                     PURPOSES FOR WHICH CORPORATION FORMED

                        The purposes for which the Corporation is formed are to
carry on any and all business,  transactions and activities permitted by the
Maryland  General  Corporation Law ("MGCL") which may be deemed desirable by the
Board of Directors of the Corporation  (the "Board"),  as well as all activities
and things necessary and incidental thereto, to the full extent empowered by the
MGCL.

                                  ARTICLE III
                      RESIDENT AGENT AND PRINCIPAL OFFICE

                        The post office  address of the principal  office of the
Corporation  in this State is 10451 Mill Run Circle,  Tenth Floor,  Owings
Mills,  Maryland  21117.  The resident agent of the Corporation in this State is
Paul A. Serini, whose post office address is 10451 Mill Run Circle, Tenth Floor,
Owings Mills,  Maryland 21117.  Said resident agent is a citizen of the State of
Maryland, and actually resides therein.


<PAGE>

                                   ARTICLE IV
                                AUTHORIZED STOCK

                        The Corporation is authorized to issue Sixty-Three
Million,  Six Hundred and Five Thousand Five Hundred and Fifty-Six  (63,605,556)
shares  of  capital  stock,  of which  Twenty  Million  Seven  Hundred  Thousand
(20,700,000)  shares are Class A Common Stock, par value of One Cent ($0.01) per
share (the "Class A Common Stock"),  Ten Million (10,000,000) shares are Class B
Common  Stock,  par value of One Cent  ($0.01)  per share  (the  "Class B Common
Stock"),  Twenty-Nine  Million Fifty  Thousand  (29,050,000)  shares are Class C
Common  Stock,  par value of One Cent  ($0.01)  per share  (the  "Class C Common
Stock")  (the  Class A Common  Stock,  the Class B Common  Stock and the Class C
Common Stock  collectively  being the "Common Stock"),  One Million  (1,000,000)
shares are  Series A  Convertible  Preferred  Stock,  par value of Five  Dollars
($5.00) per share (the "Series A Preferred  Stock"),  Three  Hundred  Fifty-Five
Thousand  Five  Hundred  Fifty-Six  (355,556)  shares are  Series B  Convertible
Preferred Stock, par value of Eleven Dollars and Twenty-Five  Cents ($11.25) per
share (the  "Series B Preferred  Stock"),  One Million,  Five  Hundred  Thousand
(1,500,000)  shares are Series C Convertible  Preferred Stock, par value Fouteen
Dollars  ($14.00) per share;  and One Million  (1,000,000)  shares are Preferred
Stock,  par  value of One Cent  ($0.01)  per  share  ("Preferred  Stock").  Upon
conversion  of the  Common  Stock  pursuant  to Article  IV,  Section  A.4,  the
Corporation  shall thereafter be authorized to issue Fifty-Nine  Million,  Seven
Hundred and Fifty Thousand  (59,750,000)  shares of Common Stock.  The aggregate
par value of all shares having par value which the  Corporation is authorized to
issue prior to  conversion  of the Common Stock  pursuant to Section A.4 of this
Article IV is Thirty  Million Six Hundred and Seven  Thousand,  Five Hundred and
Five Dollars ($30,607,505).

                        The stockholders of the Corporation shall be entitled to
vote on such matters as specifically provided herein or as otherwise required by
the MGCL. Except as otherwise provided herein,  with respect to such matters
requiring the vote of stockholders  of the Corporation  under the MGCL, the
affirmative vote of stockholders  holding  two-thirds (2/3) of the shares of
outstanding  capital  stock of the  Corporation  shall be required to  authorize
approval  of  such  matters.  The  preferences,   voting  powers,  restrictions,
limitations  as to  dividends,  rights and  qualifications  of the Common Stock,
Series A Preferred Stock, Series B Preferred Stock, Series C Preferred Stock and
Preferred Stock are as follows:

<PAGE>


            A.          COMMON STOCK.

                        Except as expressly set forth herein,  shares of Class A
Common Stock, shares of Class B Common Stock and shares of Class C Common Stock
shall have the same  preferences,  rights and voting powers,  and shall be
identical  in all  respects  and will  entitle the  holders  thereof to the same
rights and privileges. Sufficient shares of Class C Common Stock shall from time
to time be reserved by the Corporation for issuance to the holders of the shares
of Series A Preferred  Stock,  Series B  Preferred  Stock and Series C Preferred
Stock upon conversion of all of the shares of Series A Preferred Stock, Series B
Preferred  Stock and  Series C  Preferred  Stock  into  shares of Class C Common
Stock.

                        1.          VOTING RIGHTS.

                                    General Provisions.  Except as otherwise
provided herein,  every holder of Common Stock shall be entitled to cast, in
person or by proxy,  one vote for each share of Common Stock held of record by
such holder on all matters to be voted on by stockholders. The holders of shares
of Common  Stock  shall vote  together  with the  holders of shares of Series A
Preferred Stock,  Series B Preferred Stock and Series C Preferred Stock on all
matters  submitted to a vote of stockholders and not as a separate series or
class, except as otherwise provided herein.

                                    (b) Class A Common Stock.  The holders of
shares of Class A Common Stock,  voting as a single class,  shall be entitled to
elect five (5) directors of the Corporation  (the "Class A Common Directors").
The affirmative vote of a majority of the shares of Class A Common Stock
represented in person or by proxy at a meeting at which a quorum of Class A
Common Stock is present shall be sufficient to approve any matter with respect
to which  such  holders  are  entitled  to  vote;  provided,  however,  that the
affirmative vote of a plurality of all votes cast shall be sufficient to elect a
Class A Common Director.  Each share of Class A Common Stock may be voted for as
many  individuals  as there  are Class A Common  Directors  to be  elected.  The
holders  of Class A Common  Stock,  at any  annual  meeting  or upon a call of a
special  meeting of holders of Class A Common  Stock by holders of not less than
twenty-five   percent  (25%)  of  the  shares  of  Class  A  Common  Stock  then
outstanding, may remove any Class A Common Director at any time and from time to
time with or without cause, voting as a single class, by the affirmative vote of
eighty percent (80%) of all of the votes entitled to be cast for the election of
a Class A Common  Director,  and may  elect a  successor  to fill any  resulting
vacancies for the remainder of the term of such director.  If any Class A Common
Director  shall  cease  to  be a  director  for  any  reason  (including  death,
resignation,  removal or any other cause), the vacancy shall be filled by a vote
of the remaining Class A Common Directors (unless,  with respect to removal, the
holders of Class A Common Stock have elected a successor Class A Common Director
pursuant to the provisions  hereof).  If there are no such remaining  directors,
then upon a call of a special meeting of holders of Class A Common Stock, by any
such holder,  the vacancy  shall be filled by the vote of the holders of Class A
Common Stock, voting as a single class.


<PAGE>

                                 (c) Class B Common Stock.  The holders of
shares of Class B Common Stock,  voting as a single class,  shall be entitled to
elect eight (8) directors of the Corporation (the "Class B Common Directors").
The affirmative vote of a majority of the shares of Class B Common Stock
represented in person or by proxy at a meeting at which a quorum of Class B
Common Stock is present shall be sufficient to approve any matter with respect
to which  said  holders  are  entitled  to  vote;  provided,  however,  that the
affirmative vote of a plurality of all votes cast shall be sufficient to elect a
Class B Common Director.  Each share of Class B Common Stock may be voted for as
many  individuals  as there  are Class B Common  Directors  to be  elected.  The
holders  of Class B Common  Stock,  at any  annual  meeting  or upon a call of a
special  meeting of holders of Class B Common  Stock by holders of not less than
twenty-five   percent  (25%)  of  the  shares  of  Class  B  Common  Stock  then
outstanding, may remove any Class B Common Director at any time and from time to
time with or without cause, voting as a single class, by the affirmative vote of
a majority of all of the votes entitled to be cast for the election of a Class B
Common Director,  and may elect a successor to fill any resulting  vacancies for
the remainder of the term of such director. If any Class B Common Director shall
cease to be a director for any reason (including death, resignation,  removal or
any other cause), the vacancy shall be filled by a vote of the remaining Class B
Common Directors (unless, with respect to removal, the holders of Class B Common
Stock  have  elected  a  successor  Class  B  Common  Director  pursuant  to the
provisions hereof). If there are no such remaining  directors,  then upon a call
of a special meeting of holders of Class B Common Stock, by any such holder, the
vacancy  shall be filled  by the vote of the  holders  of Class B Common  Stock,
voting as a single class.

                                (d)  Class C Common  Stock. Upon  conversion  of
all of the  shares  of  Series  A  Preferred  Stock  then outstanding  into
shares of Class C Common Stock, the holders of Shares of Class C Common Stock
who were formerly holders of Series A Preferred Stock ("Converted Series A Class
C Common Stockholders"),  voting as a single sub-class,  shall be entitled to
elect two (2)  Directors  of the  Corporation  ("Converted  Series A Class C
Common  Directors").  Upon  conversion  of all of the shares of Series B
Preferred  Stock  then  outstanding  into  shares of Class C Common  Stock,  the
holders of shares of Class C Common Stock who were formerly  holders of Series B
Preferred Stock ("Converted Series B Class C Common Stockholders"),  voting as a
single  sub-class,  shall  be  entitled  to  elect  two  (2)  Directors  of  the
Corporation ("Converted Series B Class C Common Directors").  Upon conversion of
all of the shares of Series C Preferred  Stock then  outstanding  into shares of
Class C Common  Stock,  the  holders of shares of Class C Common  Stock who were
formerly holders of Series C Preferred Stock ("Converted Series C Class C Common
Stockholders"), voting as a single sub-class, shall be entitled to elect two (2)
Directors of the Corporation ("Converted Series C Class C Common Directors"). It
is the  intent of this  Section  that upon  conversion  of all of the  shares of

<PAGE>


Series A Preferred Stock,  Series B Preferred Stock and Series C Preferred Stock
then  outstanding  into shares of Class C Common Stock, the holders of shares of
Class C Common Stock,  separately  voting as  sub-classes,  shall be entitled to
elect six (6) Directors thereafter (all such directors elected by the holders of
Series A Preferred Stock,  Series B Preferred Stock and Series C Preferred Stock
being  hereinafter  referred  to  as  the  "Class  C  Common  Directors").   The
affirmative vote of a majority of the shares of Class C Common Stock represented
in person or by proxy at a meeting at which a quorum of Class C Common  Stock is
present  shall be  sufficient  to approve any matter with  respect to which said
holders are  entitled to vote,  except for matters  relating to the  election or
removal of directors.  When the Converted Series A Class C Common  Stockholders,
the Converted Series B Class C Common Stockholders or Converted Series C Class C
Common  Stockholders  vote on the election of Converted  Series A Class C Common
Directors,  Converted  Series B Class C Common  Directors or Converted  Series C
Class C Common Directors,  respectively,  the affirmative vote of a plurality of
all votes cast shall be sufficient to elect a Converted  Series A Class C Common
Director,  Converted  Series B Class C Common  Director,  or Converted  Series C
Class C Common Director,  respectively. Each share of Converted Series A Class C
Common Stock,  Converted  Series B Class C Common Stock and  Converted  Series C
Class C Common Stock may be voted for as many individuals as there are Converted
Series A Class C Common  Directors,  Converted Series B Class C Common Directors
and Converted Series C Class C Common Directors, respectively, to be elected. At
any annual  meeting or upon a call of a special  meeting of holders of Converted
Series  A Class C Common  Stock,  Converted  Series  B Class C  Common  Stock or
Converted  Series C Class C Common Stock by holders of not less than twenty-five
percent  (25%)  of the  shares  of  Converted  Series  A Class C  Common  Stock,
Converted  Series B Class C Common  Stock or  Converted  Series C Class C Common
Stock then  outstanding,  the  Converted  Series A Class C Common  Stockholders,
Converted Series B Class C Common Stockholders or the Converted Series C Class C
Common  Stockholders  may remove any Converted Series A Class C Common Director,
Converted  Series B Class C Common Director or Converted Series C Class C Common
Director, respectively, at any time and from time to time with or without cause,
voting as sub-class,  by the affirmative  vote of eighty percent (80%) of all of
the votes  entitled to be cast for the election of a Converted  Series A Class C
Common Director,  Converted Series B Class C Common Director or Converted Series
C Class C Common Director,  respectively,  and may elect a successor to fill any
resulting  vacancies  for the  remainder  of the term of such  director.  If any
Converted  Series A Class C Common  Director,  Converted Series B Class C Common
Director  or  Converted  Series C Class C Common  Director  shall  cease to be a
director  for any reason  (including  death,  resignation,  removal or any other
cause), the vacancy shall be filled by a vote of the remaining  Converted Series
A Class C  Common  Director,  Converted  Series  B Class C  Common  Director  or
Converted Series C Class C Common Director (unless with respect to removal,  the
holders of Converted  Series A Class C Common Stock,  Converted Series B Class C
Common Stock or Converted Series C Class C Common Stock have elected a successor

<PAGE>

Converted  Series A Class C Common  Director,  Converted Series B Class C Common
Director  or  Converted  Series  C  Class  C  Common  Director  pursuant  to the
provisions hereof). If there is no such remaining director,  then upon a call of
a  special  meeting  of  holders  of  Converted  Series A Class C Common  Stock,
Converted  Series B Class C Common  Stock or  Converted  Series C Class C Common
Stock,  by any such  holder,  the  vacancy  shall be  filled  by the vote of the
holders of Converted  Series A Class C Common Stock,  Converted Series B Class C
Common Stock or Converted Series C Class C Common Stock, voting as a sub-class.

                                    (e) Effect of  Conversion.  Upon  conversion
of all of the shares of Common  Stock into  shares of Class A Common  Stock
pursuant to Section A.4 of this  Article IV, every such holder of Class A Common
Stock shall be entitled to cast, in person or by proxy,  one vote for each
share of Class A Common  Stock  held of record  by such  holder on all matters
to be voted on the Stockholders and none of the additional voting rights
provided to holders of shares of Common Stock  pursuant to Section  A.1(b),  (c)
and (d) of this  Article  IV, or to  holders of the  Series A  Preferred  Stock,
Series B Preferred  Stock or Series C Preferred  Stock  pursuant to Section B.1,
Section C.1 and/or  Section D.1 of this Article IV, shall be  applicable to such
Class A Common Stock or to holders thereof. From and after such conversion, none
of the rights to dividends, redemption,  conversion or liquidation applicable to
the Series A Preferred  Stock,  Series B  Preferred  Stock or Series C Preferred
Stock  pursuant to Sections  B.2-5,  C.2-5 and D.2-5 of this Article IV shall be
applicable to such Class A Common Stock or to any holder  thereof.  Such Class A
Common Stock shall have the dividend rights and liquidation  rights set forth in
Sections 2 and 3 of this Article IV.A.

                            2.   DIVIDENDS.

                            Subject to the  provisions  of law and these
Articles,  dividends  may be declared  and paid on the Common Stock of the
Corporation  at such time and in such amounts as the Board of Directors may deem
advisable,  provided,  in all events, that no dividends may be paid with respect
to shares of Common  Stock  until such time as all shares of Series A  Preferred
Stock,  Series B Preferred Stock and Series C Preferred Stock have been redeemed
by the Corporation or converted into shares of Common Stock as provided  herein,
including  therein payment of all accrued and unpaid dividends on said shares of
Series A Preferred Stock, Series B Preferred Stock or Series C Preferred Stock.


<PAGE>


                               3. LIQUIDATION RIGHTS.

                              In the event of the dissolution,  liquidation or
winding up of the Corporation,  whether voluntary or involuntary, after payment
or  provision  for  payment of the debts and other  liabilities  of the
Corporation and the  preferential  amounts required to be paid to the holders of
Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock,
as provided  for in Sections  B.5, C.5 and D.5 of this Article IV, each share of
Common Stock shall be entitled to share  ratably with all other shares of Common
Stock in all remaining net assets of the Corporation.

                        4. CONVERSION OF CLASS A COMMON STOCK, CLASS B COMMON
                           STOCK, AND CLASS C COMMON STOCK.

                        Simultaneously  with the  consummation  of any
Qualified  or  Non-Qualified  Public  Offering (as such terms are defined in
Section B.1.(d) below)  effected by the Corporation in accordance with the
provisions of Sections B, C and D of this Article IV, each share of the
Corporation's  Class A Common Stock, Class B Common Stock, and Class C Common
Stock shall be converted, without any action on the part of the holder thereof
or the Corporation, into an identical share of the Corporation's Class A Common
Stock, and all references in these articles to Class A, Class B and Class C
Common Stock, respectively, shall be deemed to refer to the  Corporation's
Class A Common Stock,  and all special rights  granted to the holders of Class
A, Class B, and Class C Common Stock and to all holders of Series A Preferred
Stock,  Series B Preferred Stock and Series C Preferred Stock hereunder shall
cease and terminate. At least twenty (20) days prior written notice of the date
fixed and place determined for conversion shall be sent by first class mail,
postage prepaid,  to the address of every holder of shares of Common Stock as
shown in the records of the Corporation.  On or before the date  fixed for
conversion,  each  holder of shares of Common  Stock  shall surrender the
Certificates  representing  such shares to the Corporation at the place
designated in such notice and shall thereafter  receive  certificates for the
number  of full  shares  of Class A Common  Stock to which  such  holder is
entitled.

                        5.  CERTAIN PERMITTED REDEMPTIONS.

                        Notwithstanding  anything  herein to the  contrary,  the
Corporation  shall be permitted to effect  redemptions  (each a "Permitted
Redemption")  of its capital stock without the consent or approval of the Series
A Preferred Directors,  the Series B Preferred Directors, the Series C Preferred
Directors,  the holders of Series A Preferred Stock, the holders of the Series B
Preferred Stock or the holders of Series C Preferred Stock, and without granting
to the Series A Preferred  Stockholders,  the Series B Preferred Stockholders or
the Series C Preferred  Stockholders  any redemption or other rights (other than
as set forth below):

<PAGE>


                          (a) upon the payment in full of all  accumulated  and
unpaid accrued  dividends and interest on all  outstanding shares  of Series A
Preferred  Stock,  Series B  Preferred  Stock and  Series C Preferred  Stock for
all past  dividend  periods and the then  current  dividend period,  to effect a
redemption  of shares of Class A Common Stock owned by any Management
Stockholder (as defined in Section  B.1(c)(iv) hereof) as and to the extent
required  by  Section  4 of  such  Management  Stockholder's  Management
Employment  Agreement  (as  defined in  Section  B.1(c)(iv)  hereof);  provided,
however,  that any such  redemption  may be made  without any payment of accrued
dividends or interest on outstanding  shares of Series C Preferred  Stock if the
Company completes a Qualified Public Offering on or before August 30, 1998.

                            (b) to effect  redemptions  of shares  of Class A
Common  Stock  owned by any  employee  (other  than one of the Management
Stockholders) when and as approved by the Board or required by law or by the
terms of any  employment,  stock  grant or  similar  agreement  with such
employee upon such employee's death, disability,  termination of employment,  or
otherwise;

                             (c) from and after the time that there are, and
continue to be, more than  sixty-six  (66)  physicians who hold, directly or
indirectly through their professional corporations,  limited partner interests
in  Medical   Holdings  Limited   Partnership,   a  Maryland  Limited
Partnership  (the  "LP") (or an option to  purchase  such an  Interest)  (each a
"Physician  Interest  Holder"),  shares  of Class B Common  Stock  issued by the
Corporation  to the LP upon the  termination of the status of any physician as a
Physician  Interest Holder,  until such time as the number of Physician Interest
Holders is reduced to sixty-six (66) or below, in the amount deemed necessary by
the  Board of  Directors  at such  time to  ensure  that the  withdrawal  of the
Physician  Interest Holder increases the percentage  ownership  interests in the
Corporation of all other Stockholders of the Corporation to the same extent that
the indirect percentage  ownership interests in the Corporation of the remaining
Physician  Interest  Holders  are  increased.  Such  redemption  shall  be for a
redemption price, if any, equal to the amount that the Corporation  requires the
LP to pay to such withdrawing Physician Interest Holder upon his termination;

                              (d) under any other  circumstances  expressly
contemplated in the amended and restated  Stockholders  Agreement dated as of
September 4, 1996 among all of the Stockholders of the Corporation, including
any amendments thereto (the "Stockholders Agreement");

                              (e)  under any  circumstances  expressly
contemplated in Section  B.3(a),  (b) or (c) hereof with respect to the Series A
Preferred Stock;

                              (f) under any  circumstances  expressly
contemplated in Section  C.3(a),  (b) or (c) hereof with respect to the Series B
Preferred Stock, provided, however, that no such redemption, whether at the
option of any holder of the Series B Preferred Stock or at the option of the

<PAGE>

Corporation  or otherwise,  shall be permitted or effected  unless and until the
Corporation  shall have  elected  to redeem  all of the  issued and  outstanding
shares of Series A Preferred Stock prior to the effectiveness of such redemption
of Series B Preferred Stock and the Series A Redemption Price applicable to such
redemption  shall have been paid in full or adequate  provision  therefor  shall
have been made; and provided further,  however,  that nothing in this subsection
shall  permit the  Corporation  to redeem the Series A Preferred  Stock  without
consent of the holders thereof under any circumstances  not expressly  permitted
under Section B.3 hereof.

                              (g) upon the exercise by a Series B Preferred
Stockholder  of rights to require the  Corporation  to redeem its Series B
Preferred  Stock under the  circumstances  expressly  contemplated  in Section
5.3(e) of the Securities  Purchase Agreement between the Corporation and Series
B Preferred  Stockholder  dated as of  December 1, 1995 (the  "Securities
Purchase  Agreement");  provided,  however,  that no such  redemption  shall  be
permitted  or effected  unless and until the  Corporation  shall have elected to
redeem all of the  issued and  outstanding  shares of Series A  Preferred  Stock
prior to the  effectiveness  of such  redemption of Series B Preferred Stock and
the Series A Redemption Price applicable to such redemption shall have been paid
in full or  adequate  provision  therefore  shall have been made;  and  provided
further,  however,  that nothing in this subsection shall permit the Corporation
to redeem the Series A Preferred  Stock without  consent of the holders  thereof
under any circumstances not expressly permitted under Section B.3 hereof.

                              (h) under any circumstances  expressly
contemplated in Section D.3 hereof with respect to the Series C Preferred Stock,
provided, however, that no such redemption shall be permitted or effected unless
and until the Corporation shall have elected to redeem all of the issued and
outstanding  shares of Series A Preferred Stock and Series B Preferred Stock
prior to the  effectiveness  of such  redemption of Series C Preferred Stock and
the Series A Redemption  Price and Series B Redemption  Price applicable to such
redemptions  shall have been paid in full or adequate  provision  therefor shall
have been made; and provided further,  however,  that nothing in this subsection
shall permit the Corporation to redeem the Series A Preferred Stock or Series B
Preferred Stock without consent of the holders thereof under any  circumstances
not expressly permitted hereunder.

                        B.  SERIES A PREFERRED STOCK.

                            1. VOTING RIGHTS.

                            (a) General  Provisions.  Holders of Series A
Preferred  Stock shall be entitled to notice of each  meeting of all of the
Corporation's stockholders, but shall not be entitled to notice of special or
other  meetings of any class of Common Stock or of Series B Preferred Stock or
Series C Preferred  Stock.  The holders of shares of Series A Preferred Stock
shall vote  together with the holders of shares of Common Stock and Series B

<PAGE>

Preferred  Stock and Series C Preferred  Stock on all matters  submitted  to a
vote of stockholders and not as a separate series or class,  except as otherwise
provided herein. Except as otherwise provided herein, on all matters to be voted
on by the Corporation's  stockholders,  every holder of Series A Preferred Stock
shall be entitled to cast, in person or by proxy,  that number of votes equal to
the full  number of shares of Class C Common  Stock  into  which  such  holder's
Series A Preferred Stock is then convertible.

                             (b) Series A Preferred  Stock  Directors.  The
holders of shares of Series A Preferred  Stock,  voting as a single class, shall
be entitled to elect two (2)  directors of the  Corporation (the  "Series A
Preferred  Stock  Directors").  Where the  holders  of Series A Preferred Stock
vote as a class,  the  affirmative  vote of a  majority  of the shares  of
Series A  Preferred  Stock  represented  in  person or by proxy at a meeting  at
which a quorum  of  Series A  Preferred  Stock is  present  shall be sufficient
to approve any matter with respect to which said holders are entitled to vote;
provided,  however,  that the  affirmative  vote of a plurality of all votes
cast in person or by proxy by the  holders  of Series A  Preferred  Stock shall
be sufficient to elect a Series A Preferred Stock Director. The holders of
Series A Preferred  Stock,  at any properly  called annual or special meeting or
upon a call of a special  meeting  of  holders  of Series A  Preferred  Stock by
holders  of not less than  twenty-five  percent  (25%) of the shares of Series A
Preferred  Stock then  outstanding,  may remove  any  Series A  Preferred  Stock
Director  at any time and from time to time,  voting as a single  class,  by the
affirmative  vote of eighty  percent (80%) of all votes  entitled to be cast for
the election of a Series A Preferred Stock  Director,  and may elect a successor
to fill any  resulting  vacancies for the remainder of the term of such Series A
Preferred Stock  Director.  If any Series A Preferred Stock Director shall cease
to be a director for any reason  (including death,  resignation,  removal or any
other cause),  the vacancy  shall be filled by a vote of the remaining  Series A
Preferred Stock Director (unless, with respect to removal, the holders of Series
A Preferred  Stock have elected a successor  Series A Preferred  Stock  Director
pursuant to the provisions hereof). If there is no such remaining director, then
upon a call of a special meeting of holders of Series A Preferred  Stock, by any
such holder,  the vacancy shall be filled by the vote of the holders of Series A
Preferred Stock, voting as a single class.

                              (c)  Actions  Requiring  Series A  Preferred Stock
Director  Votes.  Provided  that no Series A Preferred Stockholder  is, and has
for thirty (30) days been, in Default under or pursuant to and as defined in any
promissory  note  delivered to the  Corporation by such Series A Preferred
Stockholder in partial  consideration  for the Corporation's issuance of  Series
A  Preferred  Stock  to  such  Stockholder,   without  the affirmative  vote  of
each of the  Series  A  Preferred  Stock  Directors,  the Corporation shall not:

<PAGE>


                                       (i) incur or permit any of its
Subsidiaries  (as defined in Section  B.1(d)(v)) to incur any Indebtedness  (as
defined in Section  B.1(d)(i))  as a result of which the outstanding
Indebtedness of the Corporation would on a consolidated basis exceed One Million
Dollars  ($1,000,000) in the aggregate;  other than (A) Indebtedness owing to
the Investor  named in that  certain  Financing  Transaction  Agreement dated as
of February 24, 1995,  or any of its  affiliates;  or (B)  Indebtedness incurred
under and pursuant to that certain  Credit  Agreement  and the related Credit
Agreement Document as those terms are defined in the Securities  Purchase
Agreement  dated  December  1, 1995  between  the  Corporation  and the Series B
Stockholder  (the  "Securities  Purchase  Agreement");  or (C)  Indebtedness not
exceeding  $20,000,000  incurred  under and  pursuant  to one or more  revolving
credit facilities  guaranteed by the Series A Preferred  Stockholder  and/or any
other guarantors reasonably acceptable to the Series A Preferred Stockholder; or

                                       (ii) issue any shares of its capital
stock with  liquidation or dividend rights senior to (or PARI PASSU with) the
liquidation or dividend rights of the Series A Preferred Stock; or

                                      (iii)  effect any amendment to these
Amended and Restated  Articles of  Incorporation or to the By-Laws of the
Corporation that adversely  affects the holders of the Series A Preferred Stock
or the Class C Common Stock; or

                                       (iv) effect any amendment to any of the
Amended Employment  Agreements dated February 24, 1995 by and between the
Corporation  and each of Stewart Gold  ("Gold"),  Scott Rifkin  ("Rifkin") and
Alan Kimmel  ("Kimmel")  (collectively,  the  "Management Employment
Agreements";  and Gold,  Rifkin and Kimmel each being a  "Management
Stockholder" and collectively being the "Management Stockholders"), or settle or
compromise any claim or dispute of the Corporation with respect thereto; or

                                        (v) obligate the Corporation to do any
of the foregoing.

                                (d) Definitions.  Except as otherwise expressly
provided,  for purposes of these Amended and Restated Articles, the following
words shall have the meanings set forth:

                                        (i) Unless excluded as set forth below,
"INDEBTEDNESS" shall mean (without duplication):

                                           (A) all  indebtedness  of the
                                               Corporation (as calculated on a
                                               consolidated basis by including
                                               all Indebtedness of each
                                               Subsidiary, whether or not such
                                               inclusion is required under
                                               generally accepted or other
                                               applicable accounting principles)

<PAGE>


                                               for borrowed money, the deferred
                                               purchase price of property or
                                               services, all obligations,
                                               contingent or otherwise, incurred
                                               in connection with letters of
                                               credit, credit facilities,
                                               acceptance or similar facilities,
                                               any agreement to purchase,
                                               redeem, exchange, convert or
                                               otherwise acquire any capital
                                               stock or equity securities
                                               (including, without limitation,
                                               any warrants, rights, or options
                                               to acquire such capital stock or
                                               securities of any person or
                                               entity other than a Subsidiary)
                                               now or hereafter outstanding,

                                           (B) all obligations of   the
                                               Corporation and  its Subsidiaries
                                               evidenced by bonds, notes,
                                               debentures, loan agreements,
                                               credit agreements, lines of
                                               credit or other similar
                                               instruments (including any debt
                                               securities convertible into  or
                                               exchangeable for equity
                                               securities of   the Corporation);

                                           (C) all indebtedness of   the
                                               Corporation and  its Subsidiaries
                                               created or arising under any
                                               conditional sale  or other title
                                               retention agreement with respect
                                               to property acquired (even if the
                                               rights and remedies of   the
                                               seller or lender under such
                                               agreement in   the event of
                                               default are limited to
                                               repossession or  sale of  such
                                               property);

                                           (D) all  obligations  of the
                                               Corporation  and  its
                                               Subsidiaries  under  interest
                                               rate contracts of the
                                               Corporation;

                                           (E) all obligations under leases of
                                               the Corporation and  its
                                               Subsidiaries that are capitalized
                                               by   the Corporation's
                                               accountants under generally
                                               accepted accounting principles;

                                           (F) all guarantees or surety
                                               agreements given by the
                                               Corporation and its Subsidiaries;
                                               and

                                           (G) all obligations relating to   the
                                               redemption or purchase of any
                                               capital stock of the Corporation
                                               or  its Subsidiaries (other than
                                               (x) shares of Series A Preferred
                                               Stock, or (y) capital stock of a
                                               wholly-owned Subsidiary, or (z)
                                               Permitted Redemptions pursuant to
                                               Section A.5 hereof).

<PAGE>


                        Indebtedness shall specifically  exclude, in every case,
(1) trade payables and other accrued current liabilities arising in the ordinary
course of business; and (2) any of the foregoing that

                                            (H) are incurred by the Corporation
                                                or any Subsidiary on
                                                commercially reasonable terms
                                                which do not contemplate
                                                issuance of stock or other
                                                equity interests of   the
                                                Corporation, and

                                            (I) have been approved as  part of
                                                any Business Plan (or any
                                                approved amendments thereto) for
                                                or with respect to   any
                                                calendar year. To the extent any
                                                of the foregoing are   or have
                                                been approved in  part
                                                (including as  to a portion of
                                                any such Indebtedness) in   any
                                                such Business Plan (or
                                                amendment), the approved portion
                                                only shall not   be deemed to
                                                constitute "Indebtedness" for
                                                purposes hereof.

                                    (ii)  "QUALIFIED  PUBLIC OFFERING" shall
mean any public  underwritten  offering of the  Corporation's Common Stock
pursuant to an  effective  registration  statement  filed with the Securities
and Exchange  Commission  pursuant to the Securities Act of 1933, as amended
(the  "1933  Act")  based  upon a total  market  capitalization  of the
Corporation,  at the  time of such  offering,  of at least  Twenty-Five  Million
Dollars  ($25,000,000),  from which the Corporation receives net proceeds of not
less than Fifteen Million Dollars ($15,000,000).

                                   (iii)  "NON-QUALIFIED   PUBLIC   OFFERING"
shall  mean  any   underwritten   public  offering  of  the Corporation's Common
Stock pursuant to any effective  registration  statement filed with Securities
and Exchange Commission pursuant to the 1933 Act that is not a Qualified Public
Offering.

                                    (iv)  "BUSINESS  PLAN"  means  each  plan
for  the  conduct  and  operation  of the  business  of the Corporation,  or any
portion  thereof,  which shall include a budget and contain narrative
descriptions and approximate schedules for all significant activities proposed
to be  undertaken by the  Corporation  for the period of time set forth therein,
in reasonably sufficient detail to enable the officers and directors of the
Corporation to make informed  decisions with respect to any  recommendation of,
consent to, or approval  of,  such plan and any  related  budget.  The term
"Business  Plan" shall include the "April 30 Business  Plan" which was delivered

<PAGE>

to and  reviewed  by the  Series A  Preferred  Stockholder,  and either has been
delivered to and reviewed by the professional advisors of the Series A Preferred
Stockholder or the Series A Preferred  Stockholder  has had the  opportunity to,
but elected not to, have its professional advisors review such April 30 Business
Plan,  and such April 30 Business  Plan has been  approved by the holders of the
Series A Preferred Stock for purposes of (A) Article IV Section B.1(c)(i) hereof
and (B) Article IV Section B.1(e)(i)(A) hereof.

                                      (v)  "SUBSIDIARY" means any corporation,
partnership,  limited liability  company,  joint venture or other business
entity in which the Corporation,  directly or indirectly, whether through
another Subsidiary or otherwise, by virtue of equity ownership, contract or
otherwise,  has the right to elect a majority of the board of  directors  or
other  governing  body or owns at least  50.0%  of the  total  equity  interests
thereof.

                                    (e)  Series A Preferred Stockholder Major
Decisions.

                                         (i)  GENERAL PROVISIONS.  Provided that
no Series A Preferred Stockholder is, and has for thirty (30) days been, in
Default under or pursuant to and as defined in any promissory note delivered to
the  Corporation by such Series A Preferred  Stockholder in partial
consideration for the Corporation's issuance of Series A Preferred Stock to such
Stockholder,  the Corporation shall not take any of the following actions (each,
a "Series A Preferred Stockholder Major Decision") without first submitting such
Series A Preferred Stockholder Major Decision to a vote by the holders of Series
A Preferred Stock, voting separately as a class:

                                              (A) the adoption of the
Corporation's  Business Plan (as defined in Section  B.1.(d)(iv) hereof) for any
12-month period or for calendar years 1998 and 1999, or any amendment or
periodic update to any approved Business Plan;

                                              (B) the  issuance by the
Corporation  from time to time after the date hereof of shares of its capital
stock or options,  warrants or other  rights to acquire any such shares,  to
employees  of the  Corporation,  directly or under any plan for the benefit of
the  foregoing  or the issuance of any such shares or options into an employee
stock bonus pool in an amount which,  when  aggregated  with all other such
issuances to employees of the Corporation, exceeds ten percent (10%) of the
fully diluted shares of capital stock of the  Corporation as of the date of such
issuance;  PROVIDED,  HOWEVER, that shares of Class A Common Stock (and options,
warrants and rights to acquire  shares of Class A Common  Stock) that have been,
and will after the date hereof be, issued to the three  Management  Stockholders
and other  executive  employees  of the  Corporation  in  amounts  not to exceed
twenty-five  percent (25%) of the fully  diluted  shares of capital stock of the
Corporation as of the date hereof (the "25% Management  Stock Amount") shall NOT
be counted  toward such ten percent  (10%)  limitation,  such  issuances  to the
Management Stockholders and other executive employees being expressly authorized
and consented to by the holders of the Series A Preferred Stock;

<PAGE>

                                              (C) the cessation of the business
of the Corporation;

                                              (D) the issuance of shares of
capital  stock of the  Corporation  with  liquidation  and dividend  rights
junior  to those  afforded  to the  Series A  Preferred  Stock ("Series A Junior
Stock")  to any person or entity (a "Series A Adverse  Junior Stock  Purchaser")
which has legitimate  business  interests that are materially adverse to the
holders of Series A  Preferred  Stock or any  affiliate  thereof ("Series A
Adverse Junior Stock");

                                               (E) any  sale,  transfer  or
other  disposition  by  the  Corporation  of  all  or  any substantial portion
of its assets whether by asset or stock sale or otherwise;

                                              (F) any  conveyance,  transfer or
lease by the  Corporation  of all or any  substantial portion of its assets to
any person, or to any corporation, partnership or other entity;

                                              (G) the  consolidation or merger
by the Corporation with or into another  corporation or entity, or the
consolidation or merger of another  corporation or entity with or into  the
Corporation,  where  as a  result  of such  transactions  the  voting
stockholders of the Corporation  immediately prior to such transaction would not
hold  sufficient  voting stock in the surviving  entity  immediately  after such
transaction  to elect a controlling  constituency  of the Board of Directors (or
other  governing  body)  in a  transaction  where  the  Corporation  is not  the
survivor;

                                              (H) any Non-Qualified Public
Offering;

                                              (I)  unless the  Corporation  has
previously  elected  to redeem all of the  outstanding shares  of Series A
Preferred  Stock and has paid or  adequately  provided  for payment of the
Series A Redemption  Price,  any optional  redemption of Series B Preferred
Stock pursuant to Section C.3(c) hereof; and/or

                                              (J) any agreement by the
Corporation to do any of the foregoing.

                                       (ii) CORPORATION  ENTITLED  TO  TAKE
CERTAIN  ACTIONS  WITHOUT  APPROVAL  OF  SERIES  A  PREFERRED STOCKHOLDERS.  If
a Series A Preferred Stockholder Major Decision, other than an issuance of
Series A Adverse  Junior Stock,  is not approved by the holders of a majority of
the then outstanding  shares of Series A Preferred Stock pursuant to the
provisions  of  subparagraph  (i)  hereof,   then  the  Corporation   shall

<PAGE>

nonetheless be entitled to take any of such actions constituting such a Series A
Preferred  Stockholder Major Decision,  but shall provide written notice to that
effect to the holders of Series A Preferred Stock no later than ninety (90) days
prior to the date such  action is to be  effective  and the  holders of Series A
Preferred  Stock  shall be  entitled,  by  delivery  of a written  notice to the
Corporation at the principal  office of the Corporation not less than twenty-one
(21) days  prior to the date such  action is to be  effective,  to  require  the
Corporation  to  redeem  all,  but not less  than all,  of the then  issued  and
outstanding  shares of Series A Preferred  Stock  pursuant to the  provisions of
Section B.3(a)(ii) hereof.

                                       (iii) SERIES A  ADVERSE  JUNIOR  STOCK;
SPECIAL  PROVISIONS.  If the  Series A  Preferred Stockholders  do not  approve
an  issuance  of Series A Junior  Stock that they believe  is  Series  A Adverse
Junior  Stock  pursuant  to the  provisions  of subparagraph  (i) hereof,  then,
upon the affirmative  vote of a majority of the directors of the Corporation
other than the Series A Preferred  Directors,  the Corporation shall be
entitled,  for a period of sixty (60) days  following  the election of the
holders of Series A Preferred  Stock, not to approve an issuance of such stock,
and to require  arbitration  under the expedited  procedures set forth herein of
whether the Series A Preferred  Stockholders or their affiliates have legitimate
business  interests  that  are  materially  adverse  to  such Purchaser. Such
arbitration shall be conducted by three arbitrators, two of whom (the "Party
Designated  Arbitrators") shall be selected by the parties,  and the third of
whom shall be a "Neutral  Arbitrator"  selected by the Party Designated
Arbitrators.  The Corporation shall designate its Party Designated Arbitrator in
a written notice to the holders of Series A Preferred Stock, and within five (5)
days  thereafter,  such holders of Series A Preferred  Stock shall designate its
Party  Designated  Arbitrator.  Within five (5) days  thereafter,  the two Party
Designated  Arbitrators shall agree upon and appoint a Neutral  Arbitrator,  who
shall be an attorney experienced in the health care business.  The only issue to
be  determined  in the  arbitration  shall be whether the proposed  recipient of
Series A Junior Stock has  legitimate  business  interests  which are materially
adverse to the holders of Series A Preferred  Stock.  The  arbitration  shall be
concluded  within  sixty  (60)  days of the  date of the  Corporation's  written
notice.  The  determination  of the  arbitrators so appointed shall be final and
conclusive  upon the parties.  If the  arbitrators  determine  that the proposed
purchaser is a Series A Adverse Junior Stock Purchaser, then the Corporation may
nonetheless  proceed to issue such  shares of Series A Adverse  Junior  Stock to
such  purchaser,  but shall provide written notice to that effect to the holders
of  Series  A  Preferred  Stock  no later  than 30 days  prior to the date  such
issuance  is  consummated,  and the  holders of Series A  Preferred  Stock shall
thereupon become entitled to exercise their rights to require the Corporation to
redeem  all,  but not less than all,  of the  issued and  outstanding  shares of
Series A Preferred  Stock  pursuant to the  provisions  of Section  B.3.(a)(iii)
hereof.

                                                (f) Method of  Approval.
Whenever  any action  described  herein  requires the action of holders of
Series A Preferred Stock,  such action shall be deemed to have occurred upon the

<PAGE>

approval of holders of a majority of the then issued and  outstanding  shares of
Series A Preferred Stock at a duly convened  meeting of such  stockholders or by
their written consent in accordance  with the then applicable  provisions of the
MGCL,  and the  Corporation,  in  undertaking  any action  with  respect to such
holders,  shall be entitled to rely upon a certificate signed by such holders to
that effect.

                                     2.         DIVIDENDS.

                                                 (a)        Accrual of Dividends
Before April 1,  2000. Beginning  as of February  24, 1995 and prior to April 1,
2000, cash  dividends  at the rate of thirty-two  and one half cents ($0.325)
per share per annum shall  accrue  on the  Series A Preferred  Stock (whether or
not earned or declared or payment is legally available therefor) in equal
quarterly installments, commencing on the first day of April, 1995, and
continuing thereafter on the first day of each month of July, October,  January
and April and shall accrue  interest  at the rate of 6.5% (based upon a 365 day
year) compounded quarterly on all such unpaid dividend amounts.

                                                 (b)        Payment of Dividends
Before April 1,  2000.  Dividends and interest  accrued on or with respect to
accrual dates  occurring  prior to April 1, 2000 shall be payable  (either as
part of a  Redemption  Price (as  defined  below)  or  liquidation  payment,  or
otherwise)  prior  to  April  1,  2000  only  upon  (i) the  liquidation  of the
Corporation  as herein  provided,  or (ii) the  redemption or conversion of such
share of Series A Preferred Stock, and if not paid upon liquidation,  redemption
or  conversion  on or prior to April 1,  2000,  the  amount of all such  accrued
dividends  and  interest  payments  shall from and after April 1, 2000 become an
unsecured obligation of the Corporation, bearing interest at the rate, and being
payable at the times,  set forth with  respect to  dividend  payments in Section
2(c) below.

                                                 (c)        Payment of Dividends
on or After April 1, 2000. Beginning on April 1,  2000, cash dividends,  at the
per annum rate of 100 basis points over The Wall Street  Journal  Prime Rate as
of the last business day prior to April 1, 2000, shall accrue on the original
issue price of all shares of Series A Preferred  Stock  outstanding  (whether or
not earned or declared by the Board),  in equal  quarterly  installments  on the
first day of each month of April,  July,  October and January.  All such accrued
dividends  shall be  declared  by the Board  (if funds are at such time  legally
available  therefor)  and shall be payable to each  holder of Series A Preferred
Stock on each such scheduled quarterly date (as set forth above) if, at the time
of payment funds for the full payment of such  quarterly  dividend on all shares
of Series A Preferred  Stock then  outstanding  are legally  available  therefor
under the laws of the State of Maryland as then in effect.

                                                 (d)        Right of Set Off
Against Dividends,  Redemptions,  Liquidation, etc. The Corporation may set off
against any  amounts  due and payable to any holder of Series A Preferred  Stock
(including,  but not  limited  to, any  dividend  payments,  Redemption  Prices,

<PAGE>

liquidation payments or other amounts) all or any part of any accrued but unpaid
interest on any unpaid  principal  amount owed to the Corporation by any holder,
or prior holder,  of shares of Series A Preferred Stock pursuant to the terms of
any promissory  note(s)  delivered by such holder(s) to the  Corporation for the
issuance of such shares of Series A Preferred Stock.

                                    (e)         Declaration  Date.  The date on
which the  Board  shall  consider  the  payment  of a  particular  quarterly
dividend on the Series A Preferred  Stock  pursuant  to Section  B.2.(c)  hereof
shall be any date  that is prior to the date on which  such  quarterly  dividend
would be payable if declared,  and which is not more than seventy-five (75) days
prior to such quarterly dividend payment date.

                                     (f)        Reduction of Capital.  If at any
time the Board considers the payment of any quarterly dividend pursuant  to
Section  B.2.(c)  hereof  (i) funds for the full  payment of such quarterly
dividend are not then legally available therefor under the laws of the State  of
Maryland  as  then  in  effect  as  applied  to  the then  effective
capitalization  of the  Corporation,  and (ii)  funds  for the payment  of such
quarterly  dividend would be legally available if the stated capital accounts of
the  Corporation  were reduced or capital  surplus was revalued,  then, in such
event,  the  Board  shall  reduce  the  stated  capital at least to the  extent
necessary  to declare and pay such  dividend or cause a revaluation  of capital
surplus  if  such  reduction  of  capital  or  valuation of  surplus  would  be
permissible under the laws of the State of Maryland as then in effect and unless
the exercise of the Board's fiduciary duty prevents such reduction.

                                      (g)        Limitation  on other
Dividends;  Payments.  So long as any shares of Series A  Preferred  Stock
remain  outstanding,  no dividends shall be declared or paid upon, nor shall any
dividend or other  distribution be made with respect to, any shares of any other
class or series of stock or equity interest of the Corporation or any Subsidiary
without  the consent of each of the Series A Preferred  Stock  Directors  and no
shares  of any  class of stock or  equity  interest  of the  Corporation  or any
Subsidiary  other than the shares of Series A Preferred Stock shall be redeemed,
retired, purchased or otherwise acquired by the Corporation, except purchases of
the  Corporation's  interests in a Subsidiary  at the time of its  organization.
Notwithstanding  the  foregoing,   the  Corporation  may  (i)  effect  Permitted
Redemptions  pursuant to Section A.5, and (ii) redeem shares of capital stock of
or equity interests in any wholly-owned Subsidiary.

                         3.         REDEMPTION.

                                     (a)        OPTIONAL REDEMPTION BY HOLDERS.


                                                 (i)        Permitted  Time for
Optional  Redemption.  At the  written  request  of any  holder of Series A
Preferred Stock,  sent by such holder to the Corporation at the principal office

<PAGE>

of the Corporation,  during the ninety-two (92) day period beginning on March 1,
2000, and ending on June 1, 2000, the Corporation shall, within ninety (90) days
of the date of such request (a "Series A Redemption  Date")  redeem for cash out
of any funds legally available  therefor all, but not less than all, of the then
issued and  outstanding  shares of Series A Preferred  Stock held by the holders
making such request, at an amount per share of Series A Preferred Stock equal to
the  greater  of (A) the then  "fair  market  value" (as such term is defined in
Section 3(d)(viii) below) of such share, including,  for purposes of calculating
such fair market  value,  the sum of all  accumulated  and unpaid  interest  and
dividends  on such  share  of  Series A  Preferred  Stock,  whether  or not such
dividends  have been  declared  by the  Corporation  to the date  such  share is
actually  redeemed  and  taking  into  account  any  right  of  set  off  of the
Corporation  referred to in Section B.2(d)  hereof,  or (B) the sum of the issue
price of such  share plus all  accumulated  and unpaid  interest  and  dividends
thereon,  whether or not such  dividends  have been declared by the  Corporation
(subject  to any  right of set off of the  Corporation  referred  to in  Section
B.2(d) hereof), to the date such share is actually redeemed.

                                                 (ii)       Permitted
Redemption  Resulting from Certain  Unapproved Series A Preferred  Stockholder
Major Decisions.  If the Corporation elects to take any action constituting a
Series A Preferred  Stockholder  Major  Decision  (other  than the  issuance  of
Series A Adverse  Junior Stock) without the approval of the holders of Series A
Preferred Stock (as permitted pursuant to the provisions of Section  B.1.(e)(ii)
hereof), the  Corporation  shall give notice of such  election to each holder of
Series A Preferred Stock at least ninety (90) days prior to the date such action
is to be effective,  and the holders of Series A Preferred  Stock shall be
entitled,  by delivery of a written notice to the  Corporation at the principal
office of the Corporation  not less than twenty-one (21) days prior to the date
such action is to be effective, to request the Corporation to redeem, and the
Corporation shall redeem out of any funds legally available therefor,  all (but
not less than all) of the then issued and outstanding  shares of Series A
Preferred Stock then held by the  holders  requesting  redemption,  at an
amount  per  share of  Series A Preferred  Stock equal to the greater of (A) the
then fair market  value of such share (including, for purposes of calculating
such fair market value, the sum of all  accumulated  and unpaid  interest  and
dividends on such share of Series A Preferred  Stock,  whether  or not such
dividends  have  been  declared  by the Corporation to the date such share is
actually  redeemed and taking into account any right of set off of the
Corporation  referred to in Section B.2(d) hereof), or (B) the sum of the issue
price of such share plus all  accumulated and unpaid interest and dividends
thereon, whether or not such dividends have been declared by the Corporation
(subject to any right of set off of the Corporation referred to in Section
B.2(d) hereof),  to the date such share is actually  redeemed.  To the extent
that net cash proceeds are received by the  Corporation as the result of the
taking of such action constituting such a Series A Preferred  Stockholder Major
Decision,  other than the Series A Preferred  Stockholder  Major Decisions
described  in Section  B.3(a)(iii)  below,  which  shall be treated as  provided
therein,  (i) the  Corporation  shall  pay any  redemption  price in cash to the
holders  of Series A  Preferred  Stock,  such cash to be paid pro rata among the

<PAGE>

holders  of Series A  Preferred  Stock  requesting  such  redemption  (with such
redemption being a condition precedent to the Corporation's  receipt of such net
proceeds) upon the occurrence of such action (a "Series A Redemption  Date"). To
the extent that such net cash proceeds  received by the  Corporation as a result
of taking such Series A Preferred Stockholder Major Decision are insufficient to
enable the Corporation to make full payment in cash, the Corporation may pay the
balance due with  respect to the  redemption  of such shares  within 180 days of
such request.

                                                 (iii)      Effect of Issuance
of Series A Adverse Junior Stock. If the  Corporation  elects to issue shares of
Series A Adverse  Junior  Stock  after a  determination  by the  arbitrators
appointed pursuant to Section  B.1.(e)(iii) hereof that the purchaser thereof is
a Series  A  Adverse  Junior  Stock  Purchaser,  then the  holders  of  Series A
Preferred  Stock  shall be  entitled,  by  delivery  of a written  notice to the
Corporation at the principal  office of the Corporation  within ninety (90) days
after the date of  issuance of such  shares by the  Corporation,  to request the
Corporation to redeem,  and the Corporation shall redeem,  all but not less than
all of the issued and  outstanding  shares of Series A  Preferred  Stock held by
holders  requesting  redemption.  Such redemption  payment shall be made in cash
prior to or contemporaneously  with such issuance if a request for redemption is
made thirty (30) or more days prior to the date  specified  for  issuance by the
Corporation  in its notice of  issuance,  and  otherwise no sooner than 180 days
after the date of such  request  but in all  events  within one (1) year of such
request (a "Series A Redemption Date"). The redemption price shall in all events
be an amount per share of Series A  Preferred  Stock equal to the greater of (A)
the purchase  price per share of Series A Adverse  Junior Stock to be paid, on a
fully  diluted  basis,  by the  purchaser of such  shares,  or (B) the then fair
market value of such share of Series A Preferred Stock as calculated pursuant to
subparagraph (i) hereof,  or (C) the product of (I) one and one half (1.5) times
the sum of (II) the liquidation preference of such shares, including therein all
accumulated  and unpaid  dividends  and  interest  thereon  (whether or not such
dividends have been declared by the  Corporation but subject to any right of set
off of the Corporation pursuant to Section B.2(d) hereof) to the date such share
is actually  redeemed.  Interest  shall  accrue on the amount of the fair market
value per share at a rate of six and one half percent  (6.5%) per annum from the
date such holders of Series A Preferred Stock deliver notice of their redemption
request to the  Corporation  until the full payment of all amounts  payable with
respect to such redemption has been paid in cash by the Corporation.

                                    (iv)        Permitted Special Event
Redemptions.  Upon the occurrence of a "Special Event  Redemption," as set forth
in Section  12.8  of  that  certain  Finance  Transaction   Agreement  between
the Corporation,  the  original  holder of the Series A Preferred  Stock and
others, dated as of February 24, 1995, the holders of the Series A Preferred
Stock shall have a period of sixty  (60) days from the  occurrence  of such a
Special  Event Redemption  to request the  Corporation  to redeem,  and the
Corporation  shall redeem, out of any funds legally available therefor, all (but

<PAGE>

not less than all) of the then issued and  outstanding  shares of Series A
Preferred  Stock,  at an amount per share  equal to the sum of the issue price
plus all  accumulated  and unpaid  interest and dividends  thereon  (subject to
any right of set off of the Corporation referred to in Section B.2(d) hereof),
whether or not such dividends have actually been declared.  The  Corporation
shall be entitled to satisfy any redemption  obligations  owing under this
Section  (b)(iv) by  delivering to the holders of Series A  Preferred  Stock a
promissory  note (or notes) with a term equal to the longer of (A) 24 full
months from the date of such request,  or (B) the  number  of full  months
remaining  from the date of such  request  through February 28, 1998
(collectively,  the "Final Maturity Date").  Compound interest shall  accrue on
any such note at the rate of 6 1/2 % per annum.  The  principal amount of such
note shall be amortized ratably on a 60 month basis.  Accrued and unpaid
interest shall be payable,  together with equal monthly  installments of
principal,  on the fifth day of each month  following the issuance of such note,
with a final  payment of all  accrued  and unpaid  interest  plus all  remaining
unpaid  principal due on the Final Maturity  Date.  Such note will be prepayable
without premium, will be subordinated to all then existing or thereafter created
Indebtedness,  and will contain certain such customary default and other clauses
as are customary in promissory notes of such type and amount.

                                     (B)        MANDATORY  REDEMPTION BY THE
CORPORATION.  Upon the occurrence of any  Non-Compliance (as defined in Section
B.6), the Corporation  shall redeem all, but not less than all, of the shares of
Series A  Preferred  Stock then held by each holder at the  redemption  price as
calculated  pursuant to the  provisions of Section  B.3.(a)(i),  within ten (10)
business days after the occurrence of such  Non-Compliance.  Any such redemption
shall not be in lieu of or in any way limit any other  rights which such holders
may have (at law or in equity) in connection with the event giving rise to their
right of redemption.

                                     (C)        OPTIONAL REDEMPTION BY THE
CORPORATION.

                                    (i)  Redemption  in 2000.  If the  holders
of Series A Preferred  Stock fail to request  redemption  of their  shares of
Series A  Preferred  Stock  within the  ninety-two  (92) day period  provided in
Section B.3(a)(i) hereof for such optional  redemption,  and if such shares have
not  otherwise  been  converted  to  shares  of Class C Common  Stock,  then the
Corporation may, out of funds legally available  therefor,  upon at least thirty
(30) days  prior  notice  delivered  at any time  after the  expiration  of such
applicable period (a "Series A Redemption Date"),  redeem all, but not less than
all,  of the  outstanding  shares of Series A  Preferred  Stock at an amount per
share of Series A Preferred Stock equal to the issue price of such share plus an
amount equal to the amount of all accumulated and unpaid  dividends and interest
on such share of Series A Preferred  Stock,  whether or not such  dividends have
been declared by the  Corporation  to the date such share is actually  redeemed,
minus any amount  which the  Corporation  is entitled to set off pursuant to the
provisions of Section B.2(d) hereof.

<PAGE>


                                                 (ii) REDEMPTION  UPON REDUCTION
OF NOTE. If the  Corporation  elects to defer receipt of all or any portion of
any scheduled  payment of principal due and payable to the Corporation  under
any promissory  note made by any holder of Series A Preferred  Stock in favor of
and  delivered  to the  Corporation  in  consideration  for the  issuance by the
Corporation of Series A Preferred Stock to such holder (each a "Deferred Payment
Amount"),  then the  Corporation  may, in its discretion and consistent with the
provisions  of any such  note,  redeem a number of shares of Series A  Preferred
Stock from the maker of such note determined by dividing the total amount of all
then  outstanding  Deferred  Payment  Amounts  by  five  dollars  ($5.00),  at a
redemption price of five dollars ($5.00) for each such share, and set off all or
any portion of such Deferred  Payment Amounts against any such Redemption  Price
(as defined below) due  hereunder.  The  Corporation  shall give at least thirty
(30) days  notice  to the  Series A  Preferred  Stockholders  of any  redemption
pursuant to this subsection  (ii),  which notice shall specify a redemption date
(also a Series A "Redemption Date").

                                                 (iii)  REDEMPTION  OF
REMAINING  SHARES OF SERIES A  PREFERRED  STOCK UPON  AUTOMATIC  CONVERSION.  To
the extent that shares of Series A Preferred  Stock are not converted into
shares of Class C Common  Stock  pursuant to the  provisions  of Section
B.4.(b) upon the occurrence  of the events set forth  therein,  the  Corporation
may redeem such remaining  shares of Series A Preferred  Stock upon at least ten
(10) days prior notice to the holders of Series A Preferred Stock,  which notice
shall specify a redemption date (also a Series A "Redemption  Date").  The
redemption  price for such shares shall equal, and shall be paid by,
cancellation of the entire unpaid principal  amount of the promissory  note
delivered by the holder of such shares to the Corporation in partial
consideration for the issuance of such shares.

                                     (D)        GENERAL PROVISIONS FOR
REDEMPTIONS.

                                                 (i)        Series A REDEMPTION
PRICE.  Each amount payable by the  Corporation  pursuant to Section B.3(a)
through (c) hereof respectively, is referred to as the "Series A Redemption
Price".

                                    (ii)        EFFECT OF  REDEMPTION. Provision
for  payment  of the  Series A  Redemption  Price for  shares of Series A
Preferred  Stock having been made by the  Corporation,  and for so long as there
shall be no default in the payment of deferred portions of the Redemption Price,
then (A) the shares of Series A Preferred Stock designated for redemption in any
notice  shall not be  entitled to any  dividends  accruing after the  specified
Redemption  Date, and (B) on such  Redemption  Date all rights of the respective
holders of such shares,  as  stockholders  of the Corporation  by reason of the
ownership of such shares of Series A Preferred Stock,  shall cease,  except the
right to receive the  Redemption  Price upon presentation  and surrender of the
respective certificates representing such shares.

<PAGE>

                                    (iii)       DEFERRED  PAYMENT FOR CERTAIN
APPROVED  SERIES A PREFERRED  STOCKHOLDER  MAJOR  DECISIONS.  On any Series A
Redemption  Date resulting from the failure of the holders of Series A Preferred
Stock to  approve  (A) a sale of all or  substantially  all of the assets of the
Corporation  whether by asset or stock sale,  or  otherwise,  for  consideration
other  than all cash or (B) the  Corporation  having  conveyed,  transferred  or
leased all or any substantial  portion of its assets to any person or entity, or
(C) a consolidation  or merger referred to in Section  B.1(e)(i)(G)  above,  the
Corporation  may, at its  election,  in lieu of making  payment in full in cash,
prior to the consummation of any such transaction,  pay to each holder of shares
of Series A  Preferred  Stock an amount in cash equal to  one-half  (1/2) of the
total  Series  A  Redemption  Price,  and  may  issue a  promissory  note of the
Corporation in an amount equal to the balance of such Series A Redemption Price;
provided,  however,  that in the case of (A)  above,  the  Corporation  shall be
obligated  to pay to the holders of the Series A Preferred  Stock an  additional
PRO RATA amount of cash (and shall be entitled to reduce the principal amount of
any note  referred to in (iv) below),  if and to the extent it receives any cash
as a result of such a transaction.


                                    (iv)        PROMISSORY NOTE. Any promissory
note referred to in subparagraph (iii),  above, shall be payable in two (2)
equal annual  installments, commencing on the one (1) year anniversary  of the
Series A Redemption  Date,  of principal and interest and such  interest shall
accrue at the then prime rate (the "Prime  Rate") of the Corporation's  primary
banking institution  (or,  if there be no such institution,  the prime rate of
interest as  published in the Wall Street Journal, from time to time) plus one
hundred (100) basis points.  The obligations of the Corporation to make payment
under  such note shall be secured  by a perfected  security  interest in the
Corporation's  accounts receivable  (not  more than 90 days' due at the date of
perfection) with an aggregate value of not less that 120% of all amounts payable
under  such note from  time to time,  which recurring  interest  lien  shall be
subordinated only with respect to payments and priority to any lien(s)  granted
to (A) any of the  Corporation's lending  financial institutions,  incurred in
accordance with these designations,  or (B) a Series B Preferred  Stockholder
pursuant to a Final Credit Enhancement Agreement dated December 1, 1995.

                                    (v)         RETIREMENT OF SHARES.  Shares of
Series A Preferred  Stock that have been  redeemed,  purchased or otherwise
acquired by the Corporation shall be retired and may not be reissued.

                                   (vi)       EFFECT OF LEGAL RESTRICTIONS ON
PAYMENT.  If the Redemption Price for any such shares cannot be paid in full
because  the  Corporation  is  prohibited  by law from making such payment,
then  those  funds  that  are  legally  available  will be used to pay (ratably
if  necessary)  accrued but unpaid  interest,  then  accrued but unpaid
dividends,  and then to redeem the maximum possible number of shares of Series A
Preferred Stock ratably among the holders thereof  determined by multiplying the
total  number  of  shares of Series A  Preferred  Stock to be  redeemed  times a
fraction,  the  numerator of which shall be the total number of such shares then

<PAGE>


held by each such holder and the  denominator of which shall be the total number
of such shares  then  outstanding.  The shares of Series A  Preferred  Stock not
redeemed shall remain  outstanding and be entitled to all rights and preferences
provided herein; provided, however, at any time thereafter when additional funds
of the  Corporation  are legally  available for the redemption of such shares of
Series A  Preferred  Stock,  such  funds  will be  used,  at the end of the next
succeeding fiscal quarter, to redeem the balance of such shares, or such portion
thereof  for which  funds are then  legally  available.  If fewer than the total
number of shares of Series A Preferred Stock  represented by any certificate are
redeemed, a new certificate representing the number of unredeemed shares will be
issued to the holder  thereof  without cost to such holder within three business
days after  surrender of the  certificate  representing  the redeemed  shares of
Series A Preferred Stock.

                                    (vii)       RESTRICTIONS  ON CORPORATE
ACTIONS.  If the Corporation for any reason fails to redeem any shares of Series
A  Preferred  Stock  in  accordance  with  this  Section  B.3 on or prior to the
Redemption Date specified herein, then, notwithstanding anything to the contrary
contained in these Articles of Incorporation,  the Corporation may not incur any
Indebtedness (unless the proceeds of such incurrence of Indebtedness are used to
make all overdue redemption payments in respect of the Series A Preferred Stock,
including  payments of accrued but unpaid  dividends  or  interest)  without the
prior  written  consent of the  holders of the Series A Preferred  Stock  voting
separately as a class;  provided,  however, that, subject to the restriction set
forth  in  Section  B.1(c)(i),  if  such  restriction  is  then  in  force,  the
Corporation  may incur  Indebtedness  without the aforesaid  approval if (A) the
proceeds  of such  borrowing  are  used to pay  obligations  of the  Corporation
arising in the ordinary  course of business as they become due and  payable,  or
otherwise  to maintain the  operations  of the  Corporation  at the then current
level  and not to  expand  the  operation  of the  Corporation  in any  material
respect,  whether  through  expansion or  enhancement  of, or  addition,  to the
Corporation's then current  activities,  facilities,  equipment or other capital
assets, or otherwise,  (B) the Corporation provides prior written notice of such
borrowing to all holders of Series A Preferred Stock, which notice shall include
a statement  of the  intended  use of the  proceeds of such  borrowing,  and (C)
promptly upon request  therefor,  the Corporation shall provide to any holder of
Series A  Preferred  Stock a  certificate  signed  by the  President  and  Chief
Financial Officer of the Corporation  certifying as to the allocation and use of
the proceeds of any such borrowing.

                                                 (viii)     APPRAISAL.  Within
fourteen (14) days of any written  request of any holder of shares of Series A
Preferred Stock from time to time, an appraiser or appraisers shall be jointly
selected  by  the  holders  of  Series  A  Preferred  Stock  (the  "Transferring
Stockholder"),  on the one hand, and the Corporation on the other hand, and such
jointly  selected  appraiser or appraisers shall determine the fair market value
of the Series A Preferred Stock. The fair market value of the Series A Preferred
Stock shall be such amount as of such date as the  appraisers  determine,  using

<PAGE>

such methods as the appraisers appointed hereunder determine, in the exercise of
their sole  discretion,  is  appropriate  taking into  account any  liquidation,
conversion,  preferences  or other  rights  attendant to such class (which shall
specifically  include  the value of any Class C Common  Stock  into  which  such
shares  of Series A  Preferred  Stock  may at such  time be  converted).  If the
Transferring  Stockholder,  on the one hand,  and the  Corporation  on the other
hand, do not agree upon the selection of an appraiser or appraisers,  within the
period therein stated,  then,  within seven (7) days after the expiration of the
fourteen  (14)  day  period,  the  Transferring  Stockholder  shall  appoint  an
appraiser,  and the Corporation  shall appoint a second  appraiser.  The two (2)
appraisers so appointed  shall appoint a third  appraiser  within seven (7) days
after both shall have been appointed. If either the Transferring  Stockholder or
the  Corporation  shall fail to so  appoint an  appraiser,  the  appraiser  duly
appointed  by the other shall  serve as the sole  appraiser  and such  appraiser
shall  determine the fair market value of the Series A Preferred  Stock and such
determination  shall be binding,  final and conclusive on all parties.  The said
appraiser(s)  shall,  within sixty (60) days after the last appointment  thereof
determine  the fair market  value of the Series A Preferred  Stock as  otherwise
provided herein and the  determination  of such appraiser shall be determinative
of the fair market  value of the Series A Preferred  Stock and shall be binding,
final and conclusive on all parties.  If the appraisers cannot agree on the fair
market value of the Series A Preferred  Stock,  within the time  allotted,  then
such fair  market  value  shall be the median or the two  appraisals  closest in
value to each other.  All expenses  incurred in the  appraisal  process shall be
borne and paid equally by the Transferring Stockholder and the Corporation.

                                                 (ix)       MULTIPLE  HOLDERS OF
SERIES A PREFERRED  STOCK.  If the Series A Preferred  Stock is at any time held
by more than one person or entity,  the request for redemption  pursuant to this
Section B.3 by the holders of at least fifty-one  percent (51%) of the then
issued and outstanding  shares of Series A Preferred Stock shall  constitute the
request for redemption by the holders of all of the then issued and  outstanding
shares of Series A  Preferred  Stock and all such  holders of Series A Preferred
Stock shall  redeem their  shares of Series A Preferred  Stock  pursuant to this
Section  B.3 upon the  receipt  of notice  from  holders  of at least  fifty-one
percent  (51%) of the then issued and  outstanding  shares of Series A Preferred
Stock.


                         4.         CONVERSION RIGHTS.

                                     (a)        OPTIONAL CONVERSION BY HOLDER.

                                    (i)         General  Provisions.  All, but
not less than all, of the issued and outstanding shares of Series A Preferred
Stock shall be convertible, without the payment of any additional consideration,
into shares of Class C Common Stock,  at the option of the holders of the shares
of Series A Preferred  Stock,  at any time prior to 5:00 P.M.  (EST) on February
24, 2000;  provided,  however,  that issued and  outstanding  shares of Series A

<PAGE>


Preferred  Stock may not be  converted  into  shares of Class C Common  Stock as
otherwise  permitted  herein if, at the time of such requested  conversion,  the
Corporation  has not  received  cash in full  payment for all shares of Series A
Preferred  Stock  outstanding  at such time  (including  payment  in full of all
amounts of principal and interest under any note given in partial  consideration
for  such  shares,  but less any  accrued  but  unpaid  dividends  with  respect
thereto); and provided,  further, however, that if such conversion occurs at any
time during the 60 day period referred to in Section 3(a)(ii) (other than as the
result of the  adoption  of a Business  Plan as set forth in Section  1(e)(i)(A)
(above) or pursuant to Section 3(a)(iii) above,  after the Corporation elects to
take any action  constituting  a Series A Preferred  Stockholder  Major Decision
without  the  approval  of the  holders of the Series A  Preferred  Stock,  such
conversion  shall not be deemed to be an "optional  conversion"  governed by the
provisions  of this  Section  4(a),  but  shall be  governed  by the  provisions
relating to "Automatic  Conversions" set forth in Section 4(b) below.  Each such
share of Series A  Preferred  Stock shall be  convertible  at such time into one
fully-paid  and  nonassessable  share  of  Class  C  Common  Stock,  subject  to
adjustment  as  provided  in Section  B.4.(e)  below (the  "Series A  Conversion
Rate"). The holders of shares of Series A Preferred Stock requesting  conversion
of shares into shares of Class C Common Stock shall send a written notice to the
Corporation,  at the  principal  office  of  the  Corporation,  requesting  such
conversion.  The holders shall, as soon  thereafter as practicable,  deliver the
certificates  therefor,  duly endorsed for transfer,  at the principal office of
the  Corporation  or any transfer  agent for the Series A Preferred  Stock.  The
Corporation shall, as soon as practicable  thereafter,  issue and deliver to the
holders a certificate or  certificates  for the number of such shares of Class C
Common  Stock to which the holders  shall be  entitled,  a check  payable to the
holders in the amount of any cash in lieu of issuance of any  fractional  share,
and the amount of any  cumulative  dividends and interest  accrued but unpaid on
such shares.  The conversion shall be deemed to have been made immediately prior
to the close of  business  on the date of receipt  of the  notice.  The  persons
entitled  to  receive  the  shares of Class C Common  Stock  issuable  upon such
conversion  shall be treated for all purposes as the record holder or holders of
such  shares of Class C Common  Stock on such  date,  and the shares of Series A
Preferred Stock converted shall immediately be canceled and may not be reissued.

                                                 (ii)       Multiple  Holders of
Series A Preferred  Stock.  If the Series A Preferred  Stock is at any time held
by more than one person or entity,  the request for conversion  pursuant to this
Section B.4 by the holders of at least fifty-one  percent (51%) of the then
issued and outstanding  shares of Series A Preferred Stock shall  constitute the
request for conversion by the holders of all of the then issued and  outstanding
shares of Series A  Preferred  Stock and all such  holders of Series A Preferred
Stock shall  convert their shares of Series A Preferred  Stock  pursuant to this
Section  B.4 upon the  receipt  of notice  from  holders  of at least  fifty-one
percent  (51%) of the then issued and  outstanding  shares of Series A Preferred
Stock.

<PAGE>

                        (b)         AUTOMATIC  CONVERSION.  If the holders of
Series A Preferred  Stock have not earlier  exercised  their rights to require
the  Corporation to redeem their shares of Series A Preferred  Stock pursuant to
the provisions of Section B.3.(a) hereof,  such number of outstanding  shares of
Preferred  Stock  equal to the  product of the number of  outstanding  shares of
Series A Preferred Stock multiplied by a fraction,  the numerator of which shall
be the total amount of cash paid to the  Corporation by such holders to purchase
shares of  Series A  Preferred  Stock  (but not  including  the  payment  of any
interest to the  Corporation)  and the denominator of which shall be $5 million,
shall,  together  with all other then  outstanding  shares of the  Corporation's
preferred  stock or other  capital  stock with rights to convert  into shares of
Common Stock, be converted into fully-paid and  nonassessable  shares of Class C
Common  Stock at the Series A  Conversion  Rate upon the earlier to occur of the
closing or other  consummation of (i) any Qualified  Public  Offering,  (ii) any
Non-Qualified  Public Offering,  (iii) any combination,  consolidation or merger
where the  Corporation  is not the  survivor,  (iv) any sale,  exchange or other
disposition of all or substantially all of the Corporation's assets,  whether by
asset or stock sale or otherwise, or (v) any election by the holders of Series A
Preferred  Stock to effect an  "Optional  Conversion"  during any period  during
which the holders of the Series A Preferred  Stock may cause the  Corporation to
redeem shares of their Series A Preferred  Stock  pursuant to the  provisions of
Section  3(a)(ii) or 3(a)(iii),  above.  In the case of the occurrence of any of
(i) through (v) above,  all remaining  shares of Series A Preferred  Stock which
have not been converted into shares of Class C Common Stock, shall be subject to
mandatory  redemption by the  Corporation  pursuant to the provisions of Section
B.3.(iii)  hereof.  Shares of Class C Common  Stock  received  pursuant  to this
Section 4.(b) shall be subject to the  provisions of Article IV,  Section A.4 in
the event of a Qualified Public Offering or Non-Qualified  Public Offering,  and
shall  thereupon  immediately be reclassified as shares of Class A Common Stock.
At least  twenty  (20) days  prior  written  notice of the date  fixed and place
designated for conversion shall be sent by first class mail, postage prepaid, to
the address of each holder of shares of Series A Preferred Stock as shown in the
records of the  Corporation.  On or before the date fixed for  conversion,  each
holder of shares of Series A Preferred  Stock shall  surrender the  certificates
representing  such shares to the  Corporation  at the place  designated  in such
notice and shall thereafter  receive  certificates for the number of full shares
of Common Stock to which such holder is entitled.  Until such time as holders of
certificates  theretofore  representing  shares of Series A Preferred Stock have
surrendered  them for exchange as provided  herein,  no dividends  shall be paid
with respect to any shares  represented by such  certificates and no payment for
fractional shares shall be made.

                                     (c)        NO  FRACTIONAL  SHARES.  No
fractional  shares of Common Stock shall be issued upon  conversion of shares of
Series A Preferred Stock. In lieu of any fractional share, the Corporation shall
pay a cash adjustment in respect of such  fractional  interest equal to the fair
market value of such fractional interest as determined by the Board.

<PAGE>

                                     (d)        PAYMENT;  DIVIDENDS.  At the
time of the  conversion  of any  shares of Series A  Preferred  Stock,  whether
mandatory or optional, the Corporation shall pay to the holder of such shares of
Series A  Preferred  Stock  the sum of all  interest  and  cumulative  dividends
accrued but unpaid with  respect to such shares,  whether or not such  dividends
shall have been declared by the  Corporation to the date of conversion  (subject
to the Corporation's right of set off referred to in Section B.2(d) hereof).

                                     (e)        ADJUSTMENTS;  ANTIDILUTION.  The
number of shares of Class C Common Stock  issuable  upon the  conversion of the
Series A Preferred  Stock shall be subject to  adjustment  from time to time
upon the happening of certain events as follows:

                                                 (i)        DIVIDENDS,  SPLITS.
If the Corporation  declares a dividend payable in its shares of its Common
Stock,  splits any of its Common Stock or combines any of its outstanding shares
of Common  Stock  into a smaller  number,  then the  number  of  fully-paid  and
nonassessable  shares of Class C Common  Stock into which each share of Series A
Preferred  Stock may be converted shall forthwith be adjusted by multiplying one
(1) by a  fraction  (A) the  numerator  of which  shall be the  total  number of
outstanding shares of Common Stock immediately after such dividend,  stock split
or  combination,  and (B) the  denominator of which shall be the total number of
outstanding  shares of Common Stock  immediately  prior to such dividend,  stock
split or combination.

                                                 (ii)       REORGANIZATION,
RECLASSIFICATION.  In  the  event  of  a  reorganization,  share  exchange,  or
reclassification,  other than a change in par value, or from par value to no par
value,  or  from  no par  value  to par  value  or a  transaction  described  in
subsection  (iii) or (iv) below,  each share of Series A Preferred  Stock shall,
after such reorganization,  share exchange or  reclassification,  be convertible
into the kind and number of shares of stock or other  securities  or property of
the  Corporation to which the holder of Series A Preferred Stock would have been
entitled  if the  holder  had  held  the  Class C  Common  Stock  issuable  upon
conversion  of  its  Series  A  Preferred  Stock   immediately   prior  to  such
reorganization,  share exchange,  or reclassification,  or to which the Series A
Preferred Stock is actually entitled, but not both.

                                                 (iii)      CONSOLIDATION,
MERGER,  SALE OF  ASSETS.  In the  event of a merger or  consolidation  or sale,
exchange or other  disposition of all, or substantially all of the Corporation's
assets,  to which the  Corporation is a party,  each share of Series A Preferred
Stock shall,  after such merger or  consolidation,  be convertible into the kind
and number of shares of stock and/or other securities, cash or other property to
which the  holder of such  share of Series A  Preferred  Stock  would  have been
entitled  if the  holder  had  held  the  Class C  Common  Stock  issuable  upon
conversion of its shares of Series A Preferred Stock  immediately  prior to such
consolidation  or merger or sale of assets,  or to which the Series A  Preferred
Stock is actually entitled, but not both.

<PAGE>

                                                 (iv)       CERTAIN  ISSUANCES
OF ADDITIONAL  SHARES OF COMMON  STOCK.  If the  Corporation  shall issue any
additional  shares of Common Stock -- other than  securities to be issued (i) to
the public  pursuant to any Qualified  Public Offering or  Non-Qualified  Public
Offering,  (ii) to officers,  directors, or employees of the Corporation as part
of a stock option plan,  restricted  stock plan,  employee  stock purchase plan,
employment agreement, or other employee stock plan or agreement,  implemented by
the Board,  provided that the aggregate  numbers of such shares issued shall not
exceed ten percent (10%) of the fully diluted  capital stock of the  Corporation
calculated as of the time of the issuance,  (iii) to Management Stockholders and
other  executive  employees of the  Corporation,  of an amount of Class A Common
Stock not in excess of the 25% Management Stock Amount,  (iv) upon conversion of
any shares of the Series A Preferred  Stock,  the Series B Preferred  Stock, the
Series C Preferred  Stock or the exercise of that certain Stock Warrant  granted
by the Company to the Series B Preferred Stockholder,  of even date herewith, to
purchase  88,889  shares of Class A Common  Stock at an  exercise  price that is
equal to or exceeds the "conversion price" including any adjustment thereof, (v)
upon the exercise of that certain Stock  Warrant  granted by the Company to John
R. Dwyer,  Jr.,  Stephen X. Hamilton and D. Andrew Hamilton  December 1, 1995 to
purchase in the aggregate  24,000 shares of Class A Common Stock, or (vi) to the
LP pursuant to Article XIV of the Practice Participation Agreement in respect of
the issuance of Medical  Holdings  Limited  Partnership  of the Limited  Partner
Interests (or options to purchase such  Interests)  from and after the time that
more than  sixty-six (66) but less than one hundred (100)  physicians  hold such
Limited  Partner  Interests (or options to acquire such  Interests)  directly or
indirectly  through their  professional  corporations -- for a consideration per
share of Common  Stock  less than the  "conversion  price",  as  adjusted  or as
previously  adjusted,  in effect on the date immediately prior to such issuance,
then and in such event,  such conversion  price shall be adjusted,  concurrently
with such issuance, to a price equal to the quotient obtained by DIVIDING:

                                                (1) an  amount  equal  to (x)
                        the sum of (A)  the  total  number  of  shares  of
                        Common  Stock  outstanding immediately prior to such
                        issuance or sale, plus (B) the total  number of shares
                        of Common  Stock  issuable  upon exercise  of all
                        options,  warrants  and  other  rights convertible or
                        exchangeable for, or evidencing the right to  purchase
                        shares  of,   Common  Stock   outstanding immediately
                        prior to such issuance or sale,  multiplied by the (C)
                        conversion price in effect  immediately prior to such
                        issuance or sale, plus (y) the consideration, if any,
                        received   or  deemed  to  be   received  by  the
                        Corporation upon such issuance or sale; BY

                                                (2) the sum of (A) total number
                        of shares of Common Stock  outstanding  immediately
                        after such  issuance or sale,  plus (B) the  total
                        number  of  shares of Common Stock  issuable upon
                        exercise of all options,  warrants and other rights
                        convertible  or  exchangeable  for, or evidencing the
                        right to purchase shares of, Common Stock outstanding
                        immediately after such issuance or sale.

<PAGE>

For purposes of this Section B.4, the conversion  price shall initially be $5.00
per share.

No  adjustment  of the  conversion  price  shall  be  made  under  this  Section
B.4.(e)(iv) upon the issuance of any additional  shares of Common Stock that are
issued pursuant to the exercise of any warrants,  options or other  subscription
or purchase  rights or pursuant to the  exercise of any  conversion  or exchange
rights in any convertible  securities if any such  adjustments  shall previously
have been made upon the issuance of any such  warrants,  options or other rights
or upon the issuance of any convertible  securities (or upon the issuance of any
warrants,  options or any rights  therefor)  pursuant to Sections  4(v) or 4(vi)
hereof.

                                         (v)    ISSUANCE OF WARRANTS,  OPTIONS
OR OTHER  RIGHTS.  If the  Corporation  at any time shall issue any warrants,
options or other rights to subscribe  for or purchase any  additional  shares of
Common Stock and the price per share for which additional shares of Common Stock
may at any time  thereafter be issuable  pursuant to such  warrants,  options or
other  rights  shall be less  than the  conversion  price  per  share in  effect
immediately prior to such issuance,  then such issue shall be deemed an issuance
(as of the date of issue of such warrants, options or other rights) of the total
maximum  number of shares of Common Stock  issuable  pursuant to such  warrants,
options or other rights, and the conversion price shall thereupon be adjusted as
provided  in  Section  B.4.(e)(iv)  hereof  on  the  basis  that  the  aggregate
consideration  for the additional  shares of Common Stock  issuable  pursuant to
such warrants,  options or other rights,  plus the minimum  consideration  to be
received by the  Corporation  for the  issuance of  additional  shares of Common
Stock pursuant to such warrants,  options, or other rights shall be deemed to be
the consideration received by the Corporation for the issuance of such warrants,
options, or other rights.

                                                 (vi)       CERTAIN  ISSUANCES
OF  CONVERTIBLE  SECURITIES.   In  case  the  Corporation  shall  issue  any
securities  convertible  into Common Stock and the  consideration  per share for
which  such  additional  shares of Common  Stock may at any time  thereafter  be
issuable pursuant to the terms of such convertible securities shall be less than
the  conversion  price per share in effect  immediately  prior to such issuance,
then upon  such  issuance  of such  securities  the  conversion  price  shall be
adjusted  as provided  in Section  B.4.(e)(iv)  hereof on the basis that (i) the
maximum  number of  additional  shares of Common  Stock  necessary to effect the
conversion  or exchange of all such  convertible  securities  shall be deemed to
have been issued as of the date of issuance of such convertible securities,  and
(ii) the aggregate consideration for such maximum number of additional shares of
Common Stock plus the minimum consideration  received by the Corporation for the
issuance of such additional shares of Common Stock pursuant to the terms of such
convertible  securities shall be deemed to be the consideration  received by the
Corporation for the issuance of such  convertible  securities.  No adjustment of
the conversion  price shall be made under this  subsection  upon the issuance of
any  convertible  securities  which are issued  pursuant to the  exercise of any
warrants, options or other subscription or purchase rights therefor, if any such
adjustment  shall  previously have been made upon the issuance of such warrants,
options or other rights pursuant to Section B.4.(e)(v) hereof.

                                                 (vii)      ADJUSTMENT OF SERIES
A CONVERSION  RATE. Upon each adjustment of the conversion  price under the
provisions  of this  Section  B.4.(e),  the  Series A  Conversion  Rate shall be
adjusted to an amount  determined by dividing $5.00 by such adjusted  conversion
price.  For example,  if, as a result of any of the  foregoing,  the  conversion
price was reduced to $4.00, each share of Series A Preferred Stock would then be
convertible into 1.25 shares of Class C Common Stock.

                                                 (viii)     OTHER PROVISIONS
APPLICABLE TO ADJUSTMENTS UNDER THIS SECTION.  The following provisions will be
applicable to the making of adjustments in conversion prices hereinabove
provided in this Section B.4.(e):

                                                (1)         COMPUTATION OF
CONSIDERATION.  To the extent that any additional  shares of Common Stock or any
convertible securities or any warrants, options or other rights to subscribe for
or purchase any additional shares of Common Stock or any convertible  securities
shall be  issued  for cash  consideration,  the  consideration  received  by the
Corporation  therefor  shall be deemed to be the amount of the cash  received by
the  Corporation  therefor,  or, if such  additional  shares of Common  Stock or
convertible  securities are offered by the  Corporation  for  subscription,  the
subscription   price.   To  the  extent  that  such  issuance  shall  be  for  a
consideration  other than cash, then the amount of such  consideration  shall be
deemed to be the fair value of such  consideration  at the time of such issuance
as  determined  in good  faith by the  Corporation's  Board  after  receipt of a
fairness opinion, appraisal or similar independent third party advice determined
by a person or entity jointly selected by the Series A Preferred Directors,  the
Series B Preferred  Directors,  the Series C Preferred  Directors  and the other
directors  pursuant to  procedures  substantially  similar to those set forth in
Section 6 of the Stockholders  Agreement.  The  consideration for any additional
shares of Common  Stock  issuable  pursuant  to any  warrants,  options or other
rights to subscribe for or purchase the same shall be the consideration received
by the Corporation for issuing such warrants,  options or other rights, plus the
additional  consideration  payable to the Corporation  upon the exercise of such
warrants,  options or other rights.  The consideration for any additional shares
of Common Stock  issuable  pursuant to the terms of any  convertible  securities
shall be the consideration  paid or payable to the Corporation in respect of the
subscription for or purchase of such convertible securities, plus the additional
consideration, if any, payable to the Corporation upon the exercise of the right
of  conversion  or  exchange  in  such  convertible  securities.  In case of the
issuance at any time of any  additional  shares of Common  Stock or  convertible
securities  in payment or  satisfaction  of any dividend upon any class of stock
preferred as to dividends in a fixed amount,  the Corporation shall be deemed to
have  received  for such  additional  shares  of  Common  Stock  or  convertible
securities  a  consideration  equal to the  amount of such  dividend  so paid or
satisfied.

<PAGE>

                                                (2)         READJUSTMENT  OF
CONVERSION  PRICE.  Upon the expiration of the right to convert or exchange any
convertible  securities,  or upon  the  expiration  of any  rights,  options  or
warrants,  without  conversion,  exchange  or  exercise,  the  issuance of which
convertible  securities,  rights,  options or warrants effected an adjustment in
the conversion  price,  such conversion  price shall forthwith be readjusted and
thereafter  be the price  which it would  have been  (but  reflecting  any other
adjustments  in the  conversion  price made  pursuant to the  provisions of this
Section  B.4.(e)  after the  issuance of such  convertible  securities,  rights,
options or warrants) had the  adjustment of the  conversion  price made upon the
issuance or sale of such convertible  securities or issuance of rights,  options
or  warrants  been  made on the  basis of the  issuance  only of the  number  of
additional shares of Common Stock actually issued upon conversion or exchange of
such  convertible  securities,  or upon the exercise of such rights,  options or
warrants,  and thereupon  only the number of  additional  shares of Common Stock
actually  so issued,  if any,  shall be deemed to have been  issued and only the
consideration  actually  received by the  Corporation  (computed as set forth in
subsection B.4.(e)(viii)(1) hereof) shall be deemed to have been received by the
Corporation.  If the purchase price provided for in any such rights,  options or
warrants,  or the additional  consideration (if any) payable upon the conversion
or exchange of any convertible securities,  or the rate at which any convertible
securities  are  convertible  into or  exchangeable  for shares of Common  Stock
changes at any time  (other  than under or by reason of  provisions  designed to
protect  against  dilution),  the conversion  price in effect at the time of the
change shall be adjusted to the conversion  price that would have been in effect
at such time had such rights, options,  warrants or convertible securities still
outstanding provided for such changed purchase price,  additional  consideration
or conversion rate, as the case may be, at the time initially granted, issued or
sold.

                                                (3)         OTHER ACTION
AFFECTING  COMMON STOCK.  If the Corporation  shall take any action  affecting
the outstanding  number of shares of Common Stock, other than an action
described in any of the foregoing  subsections 4(e)(i) to (vii) hereof,
inclusive,  which in the opinion of the  Corporation's  Board would have a
materially  adverse effect upon the rights of the holders of the Series A
Preferred  Stock,  the conversion price  shall be  adjusted  in such  manner
and at such  time as the  Board  may determine to be equitable in the
circumstances.

                                       (ix)     NOTICES OF ADJUSTMENTS.
Whenever the conversion rate and conversion  price is adjusted as herein
provided, an officer of the  Corporation  shall compute the adjusted  conversion
rate and conversion price in accordance with the foregoing provisions and shall
prepare a written  instrument  setting forth such adjusted  conversion rate and
conversion price and showing in detail the facts upon which such  adjustment is
based,  and such written instrument shall promptly be delivered to the record

<PAGE>

holders of the Series A Preferred  Stock,  who shall approve such  conversion
rates and prices within 30 days of receipt.  If holders of Series A Preferred
Stock do not object in writing during such 30 day period, they shall be deemed
to have approved such conversion rates and prices for all purposes hereof.

                                     (f)   RESERVATION OF SHARES.  The Board
shall at all times reserve and keep available, out of its authorized but
unissued shares of Class C Common Stock, solely for the purpose of  effecting
the  conversion of the shares of Series A Preferred Stock,  the full  number of
shares of Class C Common  Stock  deliverable  by the Corporation  upon the
conversion of all shares of Series A Preferred  Stock from time to time
outstanding  and otherwise  issuable under rights granted from the Corporation
then existing.

                                     (g)   NO IMPLIED MODIFICATION OF TERMS.
The provisions of this Section B.4. shall not give, or be deemed to give, the
Corporation the power or authority to issue any shares of its capital stock or
other  securities or to take any other action that it is expressly prohibited
from issuing by another provision hereof.

                         5.         LIQUIDATION RIGHTS.

                                     (a)        Upon any  liquidation,
dissolution or winding up of the affairs of the  Corporation,  whether voluntary
or involuntary,  the  holders of shares of the Series A  Preferred Stock  shall
be entitled  to  receive  out  of  the  assets  of the  Corporation available
for distribution to  stockholders,  before any distribution or payment shall be
made in respect of the holders of shares of Common Stock or any other class or
series of  stock  ranking  junior  to the  Series  A  Preferred Stock,  a
liquidating distribution  in an  amount  equal to the  greater  of (i) the sum
of the  "fair market  value" per share of Series A Preferred  Stock, which
shall  include an amount per share equal to all  cumulative  dividends and
interest  accrued but unpaid  thereon,  whether or not such  dividends  and
interest  shall have been declared by the Corporation,  to the date fixed for
such distribution or payment (but subject to reduction to the extent the
Corporation  exercises its right of set off referred to in Section B.2(d)
hereof);  or (ii) the sum of the original purchase price per share of Series A
Preferred Stock plus an amount equal to all cumulative  dividends and interest
accrued but unpaid thereon to the date fixed for such distribution or payment;
provided,  however,  in either such event the amount of cash  payable by the
Corporation  shall not exceed the amount of cash paid to the  Corporation  by
all  holders  of such  shares  with  respect to the purchase of such  shares,
including  the payment of any  interest  with respect thereto, through and
including the date of liquidation. The holders of shares of Series A  Preferred
Stock  shall not be  entitled  to  receive  any  additional distributive amounts
upon such  liquidation,  dissolution  or winding up of the affairs  of the
Corporation   resulting  in  any  distribution  of  assets  to stockholders.

<PAGE>


                                     (b)        If, upon any such  liquidation,
dissolution or winding up of the affairs of the Corporation,  the assets of the
Corporation to  stockholders  shall be insufficient to permit the payment in
full to the holders of Series A Preferred Stock of the amounts to which they are
entitled,  then all of such available assets shall be distributed to the holders
of shares of Series A Preferred  Stock ratably in proportion to the  liquidation
payment  otherwise due under Section  B.5.(a) to each such holder and no amounts
shall be  distributed  in  respect of any other  share of  capital  stock of the
Corporation  until all  amounts  distributable  to holders of Series A Preferred
Stock have been distributed.

                                     (c)        The purchase or redemption by
the Corporation of stock of any class,  in any manner  permitted by law, shall
not  for  the  purpose  of this  Section  B.5.  be  regarded  as a  liquidation,
dissolution  or winding up of the  Corporation.  Neither the  consolidation  nor
merger of the Corporation  with or into any other  corporation or  corporations,
nor the sale or  transfer  by the  Corporation  of all or any part of its assets
shall  be  deemed  to  be a  liquidation,  dissolution  or  winding  up  of  the
Corporation for the purpose of this Section B.5.

                                     (d)        At least thirty (30) days prior
written  notice of any such  liquidation,  dissolution  or winding up of the
affairs of the Corporation stating a payment date, the amount of the liquidation
payments and the place where said liquidation  payments shall be payable,  shall
be sent by first  class  mail,  postage  prepaid,  to each  holder  of  Series A
Preferred Stock at his address as shown on the records of the Corporation.

                         6.         EVENTS OF NON-COMPLIANCE; NON-COMPLIANCE.

                                     (a)        DEFINITION.  "Event of
Non-Compliance" shall mean, with respect to the Corporation, the occurrence of
any of the events,  occurrences or circumstances listed below; provided,
however, that any such event, occurrence or circumstance shall constitute
"Non-Compliance" if, and only if, (i) in the case of any event,  occurrence or
circumstance involving the non-payment of moneys (other than dividend and
accrued interest payments due and  payable to the  holders of Series A Preferred
Stock),  within  thirty (30) calendar days following written notice of such
non-payment, such moneys have not been paid by or on behalf of the Corporation;
and (ii) in the case of any event, occurrence or circumstance not involving the
non-payment of moneys,  substantial efforts have not been commenced by or on
behalf of the  Corporation to cure such event, occurrence, or circumstance
within a reasonable time after notice thereof (but in no event later than 30
days),  and having been so commenced,  there is a failure within a reasonable
time to prosecute to completion  with diligence and continuity the curing of
such event, occurrence or circumstances, or a period of more  than 90 days  has
occurred  without  such  cure  being  completed  to the satisfaction  of the
holders of the Series A Preferred  Stockholders;  provided, further, however,
that, for purposes of (i) and (ii) above the occurrence of any of the events,
occurrences or circumstances described in subparagraphs (5), (6) (7), (8), (9)
or (10),  below shall constitute  Non-Compliance  immediately upon its
occurrence or upon the happening of such event or circumstances, without any
requirement  of notice or passage of time  except as  specifically  set forth in
such item:

<PAGE>

                                                (1)         any failure of the
Corporation to make any payment  required to be made by it to the holders of
Series A Preferred Stock hereunder when due;

                                                (2)         any  material
default  by the  Corporation  in the  payment  of any other  material obligation
of the Corporation to any holder of Series A Preferred Stock;

                                                (3)         the  Corporation
otherwise  breaches or  otherwise  fails to perform or observe in any material
respect  any  material  covenant  or  agreement  set  forth  herein  or  in  the
Registration Rights Agreement between the Corporation and the initial holders of
the Series A  Preferred  Stock  dated  February  24,  1995 or in any  Collateral
Agreement (as defined therein).

                                                (4)         beginning  on April
1,  2000,  whenever  dividends  accruing  after  such  date on the  Series A
Preferred  Stock shall be in arrears in an aggregate  amount equal to at least 4
quarterly dividends thereon;

                                                (5)         institution  by the
Corporation  of  proceedings  of any nature under any laws or  regulations,
whether now existing or subsequently enacted or amended, for the relief of
debtors wherein the Corporation is seeking relief as debtor;

                                                (6)         a general assignment
                                                by the Corporation for the
                                                benefit of creditors;

                                                (7)         the  institution by
the Corporation of a case or other  proceeding  under any section or chapter of
the Federal Bankruptcy Code as now existing or hereafter amended or becoming
effective;

                                                (8)         the  institution
against the  Corporation  of a case or other  proceeding  under any section or
chapter of the Federal  Bankruptcy Code as now existing or hereafter  amended or
becoming  effective,  which  proceeding is not  dismissed,  stayed or discharged
within a period of ninety (90) calendar days after the filing thereto;

                                                (9)         the  appointment of
a receiving,  custodian,  trustee or like officer to take  possession of the
assets of the Corporation, if the tendency of said receivership would reasonably
tend to have a materially adverse effect upon the performance by the Corporation
of its obligations hereunder, which receivership imposition;


<PAGE>

                                               (10) admission by the Corporation
in writing of its inability to pay its debts as they mature or the Corporation
is adjudicated as insolvent;


                                                (11)        attachment,
execution  or  other  judicial  seizure  of  all  or any  substantial  part  of
the Corporation's  assets,  such  attachment,  execution  or  seizure  in  any
case remaining undismissed or undischarged for a period of fifteen (15) calendar
days after the levy thereof;  provided,  however, that said attachment,
execution or seizure  shall  not  constitute  an Event  of  Non-Compliance
hereunder  if the Corporation  posts a bond  sufficient in amount to satisfy or
secure the payment of such claim or judgment within sixty (60) calendar days
after the levy thereof and  the  Corporation's  assets  are  thereby  released
from  the  lien of such attachment;

                                                (12)        one or more
judgments or decrees is entered against the  Corporation or any of its
Subsidiaries involving  in the  aggregate a  liability  (to the extent not paid
or covered by current insurance) of the greater of (A) $100,000 with respect to
1995; $200,000 with respect to 1996;  $300,000  with respect to 1997;  $400,000
with respect to 1998; and $500,000 with respect to each year thereafter or (B)
ten percent (10%) of the net operating  earnings of the Corporation for the
immediately  preceding fiscal year, as  calculated  by the  independent
certified  public  accountants employed by the  Corporation,  and all such
judgments  or decrees have not been vacated,  discharged,  stayed or bonded
pending  appeal within 60 days from the entry thereof;

                                                (13)        defaults shall have
occurred under any agreements,  indentures,  or instruments  under which the
Corporation  then has any  outstanding  Indebtedness in excess of the greater of
(A) $100,000 with respect to 1995;  $200,000 with respect to 1996; $300,000 with
respect to 1997;  $400,000  with respect to 1998;  and $500,000  with respect to
each year  thereafter or (B) ten percent (10%) of the net operating  earnings of
the Corporation for the immediately  preceding fiscal year, as calculated by the
independent  certified  public  accountants  employed by the  Corporation in the
aggregate and if not already  matured at its final  maturity in accordance  with
its terms, such Indebtedness shall have been accelerated; and/or

                                                (14) any holder of  Indebtedness
of the  Corporation  equal to the greater of (A) $100,000  with respect to 1995;
$200,000 with respect to 1996;  $300,000  with respect to 1997;  $400,000 with
respect to 1998;  and $500,000 with respect to each year  thereafter or (B) or
ten percent (10%) of the net operating  earnings of the  Corporation  for the
immediately  preceding  fiscal year, as calculated by the independent  certified
public  accountants  employed  by the  Corporation,  after a default  under such
Indebtedness shall commence proceedings, or take any action (including by way of
set-off) to retain in  satisfaction of such  Indebtedness or to collect,  seize,
dispose  of,  or apply  in  satisfaction  of such  Indebtedness,  assets  of the
Corporation  having a fair market value in excess of the greater of (A) $100,000
with respect to 1995;  $200,000  with respect to 1996;  $300,000 with respect to
1997;  $400,000  with respect to 1998;  and  $500,000  with respect to each year


<PAGE>

thereafter  or (B) ten  percent  (10%)  of the  net  operating  earnings  of the
Corporation  for the  immediately  preceding  fiscal year,  as calculated by the
independent   certified   public   accountants   employed  by  the Corporation,
individually or in the aggregate (including funds on deposit or held pursuant to
lock-box and other similar arrangements).

                        C.          SERIES B PREFERRED STOCK.

                                                 1.         VOTING RIGHTS.

                                                 (a) General  Provisions.
Holders of Series B Preferred  Stock shall be entitled to notice of each
meeting of all of the Corporation's stockholders, but shall not be entitled to
notice of special or other  meetings of any class of Common Stock or of Series A
Preferred Stock or Series C Preferred  Stock.  The holders of shares of Series B
Preferred Stock shall vote  together with the holders of shares of Common Stock
and Series A Preferred  Stock and Series C Preferred  Stock on all matters
submitted  to a vote of stockholders and not as a separate series or class,
except as otherwise provided herein. Except as otherwise provided herein, on all
matters to be voted on by the Corporation's  stockholders,  every holder of
Series B Preferred Stock shall be entitled to cast, in person or by proxy,  that
number of votes equal to the full  number of shares of Class C Common  Stock
into  which  such  holder's Series B Preferred Stock is then convertible.

                                                 (b) Series B Preferred  Stock
Directors.  The holders of shares of Series B Preferred  Stock,  voting as a
single class,  shall be entitled to elect two (2)  directors of the  Corporation
(the  "Series B  Preferred  Stock  Directors").  Where the  holders  of Series B
Preferred  Stock vote as a class,  the  affirmative  vote of a  majority  of the
shares  of  Series B  Preferred  Stock  represented  in  person or by proxy at a
meeting  at which a quorum  of  Series B  Preferred  Stock is  present  shall be
sufficient to approve any matter with respect to which said holders are entitled
to vote;  provided,  however,  that the  affirmative  vote of a plurality of all
votes  cast in person or by proxy by the  holders  of Series B  Preferred  Stock
shall be sufficient to elect a Series B Preferred Stock Director. The holders of
Series B  Preferred  Stock,  at any  annual  meeting or upon a call of a special
meeting  of  holders  of Series B  Preferred  Stock by  holders of not less than
twenty-five  percent  (25%) of the  shares  of  Series B  Preferred  Stock  then
outstanding,  may remove any Series B Preferred  Stock  Director at any time and
from time to time,  voting as a single class, by the affirmative  vote of eighty
percent  (80%) of all votes  entitled to be cast for the  election of a Series B
Preferred  Stock  Director,  and may  elect a  successor  to fill any  resulting
vacancies  for the  remainder  of the  term of such  Series  B  Preferred  Stock
Director.  If any Series B Preferred Stock Director shall cease to be a director
for any reason (including death,  resignation,  removal or any other cause), the
vacancy  shall be filled by a vote of the  remaining  Series B  Preferred  Stock
Director  (unless,  with  respect to removal,  the holders of Series B Preferred
Stock have elected a successor Series B Preferred Stock Director pursuant to the
provisions hereof). If there is no such remaining director,  then upon a call of

<PAGE>

a special  meeting of holders of Series B Preferred  Stock,  by any such holder,
the  vacancy  shall be filled by the vote of the  holders of Series B  Preferred
Stock, voting as a single class.

                                                 (c) Actions  Requiring  Series
B Preferred  Stock Director Votes.  Without the affirmative  vote of each of the
Series B Preferred Stock Directors, the Corporation shall not:

                                                             (i)        incur or
permit any of its Subsidiaries  (as defined in Section  B.1(d)(v)) to incur any
Indebtedness  (as  defined in Section  B.1(d)(i))  as a result of which the
outstanding Indebtedness of the Corporation would on a consolidated basis exceed
One Million Dollars  ($1,000,000) in the aggregate;  other than (A) Indebtedness
owing to the Investor  named in that  certain  Financing  Transaction  Agreement
dated as of February 24, 1995,  or any of its  affiliates,  or (B)  Indebtedness
incurred  under and pursuant to that certain  Credit  Agreement  and the related
Credit Agreement Documents as defined in the Securities  Purchase Agreement,  or
(C) Indebtedness not exceeding $20,000,000 incurred under and pursuant to one or
more  revolving  credit   facilities   guaranteed  by  the  Series  A  Preferred
Stockholder  and/or any other guarantors  reasonably  acceptable to the Series B
Preferred Stockholder; or

                                                             (ii)       issue
any shares of its capital stock with  liquidation or dividend rights senior to
(or PARI PASSU with) the liquidation or dividend rights of the Series B
Preferred Stock; or

                                                             (iii)      effect
any amendment to these Amended and Restated  Articles of  Incorporation or to
the By-Laws of the Corporation that adversely  affects the holders of the Series
B Preferred Stock or the Class C Common Stock; or

                                                             (iv)       effect
any amendment to any of the Amended Employment  Agreements dated February 24,
1995 by and between the  Corporation  and each of Stewart Gold  ("Gold"),  Scott
Rifkin  ("Rifkin") and Alan Kimmel  ("Kimmel")  (collectively,  the  "Management
Employment  Agreements";  and Gold,  Rifkin and Kimmel each being a  "Management
Stockholder" and collectively being the "Management Stockholders"), or settle or
compromise any claim or dispute of the Corporation with respect thereto; or

                                                             (v)        obligate
the Corporation to do any of the foregoing.

                                    (d)         Definitions.  For  purposes  of
this  Section  C, the  definitions  set forth in  Section  B.1.(d)  shall be
applicable except that:

                                                             (i)         In
Section B.1(d)(i)(G)(x), the phrase "Series B Preferred Stock" shall be
substituted for "Series A Preferred Stock;"


<PAGE>

                                                (ii)        "QUALIFIED  PUBLIC
OFFERING" shall mean any public  underwritten  offering of the  Corporation's
Common Stock  pursuant to an  effective  registration  statement  filed with the
Securities  and Exchange  Commission  pursuant to the Securities Act of 1933, as
amended  (the  "1933  Act")  based  upon a total  market  capitalization  of the
Corporation,  at the  time of such  offering,  of at  least  Forty-Five  Million
Dollars ($45,000,000).

                                                (iii)       "BUSINESS  PLAN"
means  each  plan  for  the  conduct  and  operation  of the  business  of the
Corporation,  or any portion  thereof,  which shall include a budget and contain
narrative  descriptions and approximate schedules for all significant activities
proposed to be  undertaken by the  Corporation  for the period of time set forth
therein, in reasonably sufficient detail to enable the officers and directors of
the  Corporation to make informed  decisions with respect to any  recommendation
of,  consent to, or approval  of,  such plan and any  related  budget.  The term
"Business  Plan" shall include the "April 30 Business  Plan" which was delivered
to and  reviewed  by the  Series B  Preferred  Stockholder,  and either has been
delivered to and reviewed by the professional advisors of the Series B Preferred
Stockholder or the Series B Preferred  Stockholder  has had the  opportunity to,
but elected not to, have its professional advisors review such April 30 Business
Plan,  and such April 30 Business  Plan has been  approved by the holders of the
Series B Preferred Stock for purposes of (A) Article IV Section C.1(c)(i) hereof
and (B)  Article IV Section  C.1(e)(i)(A)  hereof.  The  Corporation's  April 30
Business  has been  approved by the holder of the Series B  Preferred  Stock for
purposes of (A) Section C.1(c)(i) hereof; and (B) Section C.1(e)(i)(A) hereof.

                                    (e)         Series B Preferred Stockholder
                                    Major Decisions.

                                                (i)         GENERAL  PROVISIONS.
The  Corporation  shall not take any of the  following  actions  (each,  a
"Series B Preferred  Stockholder Major Decision")  without first submitting such
Series B Preferred Stockholder Major Decision to a vote by the holders of Series
B Preferred Stock, voting separately as a class:

                                                            (A)         the
adoption of the Corporation's  Business Plan (as defined in Section  C.1.(d)(iv)
hereof) for any 12-month period or for calendar years 1998 and 1999, or any
amendment or periodic update to any approved Business Plan;

                                                            (B)         the
issuance by the  Corporation  from time to time after the date hereof of shares
of its capital  stock or options,  warrants or other  rights to acquire any such
shares,  to  employees  of the  Corporation,  directly or under any plan for the
benefit of the  foregoing  or the issuance of any such shares or options into an
employee  stock bonus pool in an amount which,  when  aggregated  with all other
such issuances to employees of the Corporation, exceeds ten percent (10%) of the
fully diluted shares of capital stock of the  Corporation as of the date of such
issuance;  PROVIDED,  HOWEVER, that shares of Class A Common Stock (and options,
warrants and rights to acquire  shares of Class A Common  Stock) that have been,
and will after the date hereof be, issued to the three  Management  Stockholders

<PAGE>

and other  executive  employees  of the  Corporation  in  amounts  not to exceed
twenty-five  percent (25%) of the fully  diluted  shares of capital stock of the
Corporation as of the date hereof (the "25% Management  Stock Amount") shall NOT
be counted  toward such ten percent  (10%)  limitation,  such  issuances  to the
Management Stockholders and other executive employees being expressly authorized
and consented to by the holders of the Series B Preferred Stock;

                                                            (C)         the
cessation of the business of the Corporation;

                                                            (D)         the
issuance of shares of capital  stock of the  Corporation  with  liquidation  and
dividend  rights  junior  to those  afforded  to the  Series B  Preferred  Stock
("Series B Junior  Stock")  to any person or entity (a "Series B Adverse  Junior
Stock  Purchaser")  which is actively engaged in substantially the same business
or businesses in which any corporation  which owns more that fifty percent (50%)
of the  voting  capital  stock of the  holder  of  Series B  Preferred  Stock is
actively engaged ("Series B Adverse Junior Stock");

                                                            (E)         any
sale,  transfer  or  other  disposition  by  the  Corporation  of  all  or  any
substantial portion of its assets whether by asset or stock sale or otherwise;

                                                            (F)         any
conveyance,  transfer  or lease by the  Corporation  of all or any  substantial
portion of its assets to any person, or to any corporation, partnership or other
entity;

                                                            (G)         the
consolidation or merger by the Corporation with or into another  corporation or
entity, or the consolidation or merger of another  corporation or entity with or
into  the  Corporation,  where  as a  result  of such  transactions  the  voting
stockholders of the Corporation  immediately prior to such transaction would not
hold  sufficient  voting stock in the surviving  entity  immediately  after such
transaction  to elect a controlling  constituency  of the Board of Directors (or
other  governing  body)  in a  transaction  where  the  Corporation  is not  the
survivor;


                                                            (H)         any
Non-Qualified Public Offering;

                                                            (I)         any
agreement by the Corporation to do any of the foregoing.

                                                            (J)         any
amendment  subsequent  to the date hereof to that  certain  Physician  Services
Organization  Agreement  by and between  Baltimore  Medical  Group,  LLC and BMG
Limited  Partnership,  dated as of February 24, 1995 (which has been assigned by
BMG Limited  Partnership  (now  Medical  Holdings  Limited  Partnership)  to the


<PAGE>


Corporation) (the "PSO Agreement"), that materially adversely affects the Series
B Preferred Stockholder in its capacity as the Series B Preferred Stockholder.

                                                            (K)         Such
other  actions  or  proposed  actions  by the  Corporation  that the  Series B
Preferred  Stockholder and the Corporation shall, in a written agreement between
them (a "Major Decision Agreement"),  agree shall constitute additional Series B
Preferred Stock Major Decisions requiring the affirmative vote or consent of the
Series B Preferred Stockholder.  A Major Decision Agreement may provide remedies
to the Series B Preferred  Stockholder for the Corporation's  failure or refusal
to secure the affirmative vote or consent of the Series B Preferred  Stockholder
for any such additional  Major Decision,  in addition to the remedies  otherwise
provided by these Articles.

                                                  (ii)      CORPORATION
ENTITLED  TO  TAKE  CERTAIN  ACTIONS  WITHOUT  APPROVAL  OF  SERIES  B
PREFERRED STOCKHOLDERS.  If a Series B Preferred Stockholder Major Decision,
other than an issuance of Series B Adverse  Junior Stock,  is not approved by
the holders of a majority of the then outstanding  shares of Series B Preferred
Stock pursuant to the  provisions  of  subparagraph  (i)  hereof,   then  the
Corporation   shall nonetheless be entitled to take any of such actions
constituting such a Series B Preferred  Stockholder Major Decision,  but shall
provide written notice to that effect to the holders of Series B Preferred Stock
no later than ninety (90) days prior to the date such  action is to be
effective  and the  holders of Series B Preferred  Stock  shall be  entitled,
by  delivery  of a written  notice to the Corporation at the principal  office
of the Corporation not less than twenty-one (21) days  prior to the date such
action is to be  effective,  to  require  the Corporation  to  redeem  all,  but
not less  than all,  of the then  issued  and outstanding  shares of Series B
Preferred  Stock  pursuant to the  provisions of Section C.3(a)(ii) hereof.

                                                             (iii)      SERIES B
ADVERSE  JUNIOR  STOCK;  SPECIAL  PROVISIONS.  If the  Series B  Preferred
Stockholders  do not  approve  an  issuance  of Series B Junior  Stock that they
believe  is  Series  B  Adverse  Junior  Stock  pursuant  to the  provisions  of
subparagraph  (i) hereof,  then, upon the affirmative  vote of a majority of the
directors of the Corporation  other than the Series B Preferred  Directors,  the
Corporation  shall be entitled,  for a period of sixty (60) days  following  the
election of the holders of Series B Preferred  Stock, not to approve an issuance
of such stock,  and to require  arbitration  under the expedited  procedures set
forth herein of whether the Series B Preferred  Stockholders or their affiliates
have  legitimate   business  interests  that  are  materially  adverse  to  such
Purchaser. Such arbitration shall be conducted by three arbitrators, two of whom
(the "Party Designated  Arbitrators") shall be selected by the parties,  and the
third of whom shall be a "Neutral  Arbitrator"  selected by the Party Designated
Arbitrators.  The Corporation shall designate its Party Designated Arbitrator in
a written notice to the holders of Series B Preferred Stock, and within five (5)
days  thereafter,  such holders of Series B Preferred  Stock shall designate its
Party  Designated  Arbitrator.  Within five (5) days  thereafter,  the two Party


<PAGE>

Designated  Arbitrators shall agree upon and appoint a Neutral  Arbitrator,  who
shall be an attorney experienced in the health care business.  The only issue to
be  determined  in the  arbitration  shall be whether the proposed  recipient of
Series B Junior Stock has  legitimate  business  interests  which are materially
adverse to the holders of Series B Preferred  Stock.  The  arbitration  shall be
concluded  within  sixty  (60)  days of the  date of the  Corporation's  written
notice.  The  determination  of the  arbitrators so appointed shall be final and
conclusive  upon the parties.  If the  arbitrators  determine  that the proposed
purchaser is a Series B Adverse Junior Stock Purchaser, then the Corporation may
nonetheless  proceed to issue such  shares of Series B Adverse  Junior  Stock to
such  purchaser,  but shall provide written notice to that effect to the holders
of  Series  B  Preferred  Stock  no later  than 30 days  prior to the date  such
issuance  is  consummated,  and the  holders of Series B  Preferred  Stock shall
thereupon become entitled to exercise their rights to require the Corporation to
redeem  all,  but not less than all,  of the  issued and  outstanding  shares of
Series B Preferred  Stock  pursuant to the  provisions  of Section  C.3.(a)(iii)
hereof.

                                                 (f)        Method of  Approval.
Whenever  any action  described  herein  requires the action of holders of
Series B Preferred Stock,  such action shall be deemed to have occurred upon the
approval of holders of a majority of the then issued and  outstanding  shares of
Series B Preferred Stock at a duly convened  meeting of such  stockholders or by
their written consent in accordance  with the then applicable  provisions of the
MGCL,  and the  Corporation,  in  undertaking  any action  with  respect to such
holders,  shall be entitled to rely upon a certificate signed by such holders to
that effect.

                                     2.         DIVIDENDS.

                                                 (a)        Accrual of
Dividends  Before  April 1,  2000.  Beginning  as of  December  1, 1995 and
prior to April  1,  2000,  cash  dividends  at  the  rate  of One  Dollar  and
Nine  and Seven-Tenths  Cents  ($1.097)  per share per annum shall  accrue on
the Series B Preferred  Stock  (whether  or not  earned or  declared  or
payment  is legally available therefor) in equal quarterly installments,
commencing on the first day of January  1996,  and  continuing  thereafter on
the first day of each month of April,  July,  October,  January and shall accrue
interest at the rate of 9.75% (based upon a 365 day year)  compounded  quarterly
on all such unpaid  dividend amounts.

                                                 (b)        Payment of Dividends
Before April 1, 2000.  Dividends  and interest  accrued on or with respect to
accrual dates  occurring  prior to April 1, 2000 shall be payable  (either as
part of a Series B Redemption  Price (as defined below) or liquidation  payment,
or  otherwise)  prior to April 1, 2000 only  after all  dividends  and  interest
accrued on or with respect to the Series A Preferred  Stock have been fully paid
and only upon (i) the liquidation of the Corporation as herein provided, or (ii)
the redemption or conversion of such share of Series B Preferred  Stock,  and if
not paid upon  liquidation,  redemption  or  conversion  on or prior to April 1,


<PAGE>

2000, the amount of all such accrued  dividends and interest payments shall from
and after  April 1, 2000  become an  unsecured  obligation  of the  Corporation,
bearing  interest  at the rate,  and being  payable at the  times,  and upon the
conditions, set forth with respect to dividend payments in Section 2(c) below.

                                                 (c)        Payment of Dividends
on or After April 1, 2000.  Beginning on April 1, 2000, cash dividends,  at the
per annum rate of 100 basis points over The Wall Street  Journal  Prime Rate as
of the last business day prior to April 1, 2000, shall accrue on the original
issue price of all shares of Series B Preferred  Stock  outstanding  (whether or
not earned or declared by the Board),  in equal  quarterly  installments  on the
first day of each month of April,  July,  October and January.  All such accrued
dividends  shall be  declared  by the Board  (if funds are at such time  legally
available  therefor)  and shall be payable to each  holder of Series B Preferred
Stock on each such scheduled quarterly date (as set forth above) if, at the time
of payment (i) all dividends and interest accrued on or declared with respect to
the Series A Preferred  Stock have been fully paid,  and (ii) funds for the full
payment of such  quarterly  dividend on all shares of Series B  Preferred  Stock
then outstanding are legally  available  therefor under the laws of the State of
Maryland as then in effect.

                                                 (d)        Declaration  Date.
The date on which the Board  shall  consider  the  payment  of a  particular
quarterly  dividend on the Series B Preferred  Stock pursuant to Section C.2.(c)
hereof  shall be any date  that is  prior  to the date on which  such  quarterly
dividend would be payable if declared,  and which is not more than  seventy-five
(75) days prior to such quarterly dividend payment date.

                                                 (e)        Reduction of
Capital.  If at any time the Board considers the payment of any quarterly
dividend pursuant  to  Section  C.2.(c)  hereof  (i) funds for the full  payment
of such quarterly dividend are not then legally available therefor under the
laws of the State  of  Maryland  as  then  in  effect  as  applied  to  the
then  effective capitalization  of the  Corporation,  and (ii)  funds  for the
payment  of such quarterly  dividend would be legally available if the stated
capital accounts of the  Corporation  were reduced or capital  surplus was
revalued,  then, in such event,  the  Board  shall  reduce  the  stated  capital
at least to the  extent necessary  to declare and pay such  dividend or cause a
revaluation  of capital surplus  if  such  reduction  of  capital  or  valuation
of  surplus  would  be permissible under the laws of the State of Maryland as
then in effect and unless the exercise of the Board's fiduciary duty prevents
such reduction.

                                                 (f)        Limitation  on other
Dividends;  Payments.  So long as any shares of Series B  Preferred  Stock
remain  outstanding,  (i) no dividends shall be declared or paid upon, nor shall
any  dividend or other  distribution  be made with respect to, any shares of any
other class or series of stock or equity interest of the Corporation  other than
the Series A Preferred  Stock or any  Subsidiary  without the consent of each of

<PAGE>

the Series B Preferred Stock Directors, and (ii) no shares of any class of stock
or equity interest of the Corporation or any Subsidiary other than the shares of
Series B  Preferred  Stock  and  Series A  Preferred  Stock  shall be  redeemed,
retired, purchased or otherwise acquired by the Corporation, except purchases of
the  Corporation's  interests in a Subsidiary  at the time of its  organization.
Notwithstanding  the  foregoing,  the  Corporation  may  (iv)  effect  Permitted
Redemptions  pursuant to Section A.5; and (v) may redeem shares of capital stock
of or equity interests in any wholly-owned Subsidiary.

<PAGE>


                         3.         REDEMPTION.

                                     (a)        OPTIONAL REDEMPTION BY HOLDERS.


                                                 (i)        Permitted  Time for
Optional  Redemption.  At the  written  request  of any  holder of Series B
Preferred Stock,  sent by such holder to the Corporation at the principal office
of the Corporation,  during the ninety-two (92) day period beginning on March 1,
2000, and ending on June 1, 2000, the Corporation shall, within ninety (90) days
of the date of such request (a "Series B Redemption  Date")  redeem for cash out
of any funds legally available  therefor all, but not less than all, of the then
issued and  outstanding  shares of Series B Preferred  Stock held by the holders
making such request, at an amount per share of Series B Preferred Stock equal to
the  greater  of (A) the then  "fair  market  value" (as such term is defined in
Section  3(d)(ix) below) of such share,  including,  for purposes of calculating
such fair market  value,  the sum of all  accumulated  and unpaid  interest  and
dividends  on such  share  of  Series B  Preferred  Stock,  whether  or not such
dividends  have been  declared  by the  Corporation  to the date  such  share is
actually  redeemed,  or (B) the sum of the issue  price of such  share  plus all
accumulated  and unpaid  interest  and  dividends  thereon,  whether or not such
dividends  have been  declared  by the  Corporation  to the date  such  share is
actually redeemed.

                                                 (ii)       Permitted
Redemption  Resulting from Certain  Unapproved Series B Preferred  Stockholder
Major Decisions.  If the Corporation elects to take any action constituting a
Series B Preferred  Stockholder  Major  Decision  (other  than the  issuance  of
Series B Adverse  Junior Stock) without the approval of the holders of Series B
Preferred Stock (as permitted pursuant to the provisions of Section  B.1.(e)(ii)
hereof), the  Corporation  shall give notice of such  election to each holder of
Series B Preferred Stock at least ninety (90) days prior to the date such action
is to be effective,  and the holders of Series B Preferred  Stock shall be
entitled,  by delivery of a written notice to the  Corporation at the principal
office of the Corporation  not less than twenty-one (21) days prior to the date
such action is to be effective, to request the Corporation to redeem, and the
Corporation shall redeem out of any funds legally available therefor,  all (but
not less than all) of the then issued and outstanding  shares of Series B
Preferred Stock then held by the  holders  requesting  redemption,  at an
amount  per  share of  Series B Preferred  Stock equal to the greater of (A) the
then fair market  value of such share (including, for purposes of calculating
such fair market value, the sum of all  accumulated  and unpaid  interest  and
dividends on such share of Series B Preferred  Stock,  whether  or not such
dividends  have  been  declared  by the Corporation  to the date such share is
actually  redeemed) or (B) the sum of the issue price of such share plus all
accumulated and unpaid interest and dividends thereon,  whether or not such
dividends have been declared by the Corporation to the date such share is
actually  redeemed.  To the extent that net cash proceeds are  received  by the
Corporation  as the result of the  taking of such  action constituting such a
Series B Preferred  Stockholder  Major Decision,  other than the  Series  B

<PAGE>

Preferred  Stockholder  Major  Decisions  described  in  Section C.3(a)(iii)
below,  which  shall  be  treated  as  provided  therein,  (i)  the Corporation
shall pay any  redemption  price in cash to the holders of Series B Preferred
Stock,  such cash to be paid pro rata  among the  holders of Series B Preferred
Stock  requesting  such  redemption  (with  such  redemption  being a condition
precedent to the Corporation's  receipt of such net proceeds) upon the
occurrence  of such action (a "Series B  Redemption  Date").  To the extent that
such net cash proceeds  received by the  Corporation  as a result of taking such
Series B Preferred  Stockholder  Major Decision are  insufficient  to enable the
Corporation  to make full payment in cash, the  Corporation  may pay the balance
due with  respect  to the  redemption  of such  shares  within  180 days of such
request.

                                                 (iii)      Effect of Issuance
of Series B Adverse Junior Stock. If the  Corporation  elects to issue shares of
Series B Adverse  Junior  Stock  after a  determination  by the  arbitrators
appointed pursuant to Section C.1(e)(iii) hereof that the purchaser thereof is a
Series B Adverse Junior Stock Purchaser,  then the holders of Series B Preferred
Stock shall be entitled,  by delivery of a written notice to the  Corporation at
the principal  office of the Corporation  within ninety (90) days after the date
of issuance of such shares by the  Corporation,  to request the  Corporation  to
redeem,  and the  Corporation  shall  redeem,  all but not less  than all of the
issued  and  outstanding  shares of Series B  Preferred  Stock  held by  holders
requesting redemption. Such redemption payment shall be made in cash prior to or
contemporaneously  with such issuance if a request for redemption is made thirty
(30) or more days prior to the date specified for issuance by the Corporation in
its notice of issuance,  and otherwise no sooner than 180 days after the date of
such request but in all events  within one (1) year of such request (a "Series B
Redemption  Date").  The Corporation shall also, on or before the effective date
of such redemption,  secure the complete and  unconditional  release of all then
effective  guarantees of indebtedness of the Corporation by the redeeming Series
B  Stockholder  and shall also pay or cause to be paid in full all of the monies
owed by the Corporation to such redeeming Series B Stockholder pursuant to or as
a result  of such  guarantee  or any  instrument,  agreement  or other  document
executed and delivered by the Corporation to the redeeming  Series B Stockholder
to induce the redeeming  Series B Stockholder to enter into such guarantee.  The
redemption  price  shall in all  events  be an  amount  per  share  of  Series B
Preferred  Stock  equal to the  greater of (A) the  purchase  price per share of
Series B Adverse  Junior  Stock to be paid,  on a fully  diluted  basis,  by the
purchaser  of such  shares,  or (B) the then fair market  value of such share of
Series B Preferred Stock as calculated  pursuant to subparagraph (i) hereof,  or
(C) the  product  of (I)  one  and one  half  (1.5)  times  the sum of (II)  the
liquidation  preference of such shares,  including  therein all  accumulated and
unpaid  dividends and interest  thereon (whether or not such dividends have been
declared  by the  Corporation)  to the date  such  share is  actually  redeemed.
Interest shall accrue on the amount of the fair market value per share at a rate
of nine and  three-fourths  percent (9.75%) per annum from the date such holders
of Series B Preferred  Stock deliver notice of their  redemption  request to the
Corporation  until the full payment of all amounts  payable with respect to such
redemption has been paid in cash by the Corporation.

<PAGE>

                                                (iv)        Redemption  Pursuant
to Securities  Purchase  Agreement.  Upon the written request of the holder of
Series B Preferred  Stock pursuant to Section 5.3(e) the Securities  Purchase
Agreement,  the Corporation shall redeem the then issued and outstanding  shares
of Series B Preferred  Stock held by such holder  according  to the terms of the
Securities Purchase Agreement.

                                   (B)  MANDATORY  REDEMPTION BY THE
CORPORATION. Upon the occurrence of any  Non-Compliance  (as defined in Section
C.6), the Corporation  shall  redeem all, but not less than all, of the shares
of Series B Preferred  Stock then held by each holder at the redemption  price
as calculated pursuant to the provisions of Section C.3.(a)(i),  within ten (10)
business days after the occurrence of such Non-Compliance. Any such redemption
shall not be in lieu of or in any way limit any other rights which such holders
may have (at law or in  equity)  in  connection  with the  event  giving  rise
to their  right of redemption.

                                     (C)        OPTIONAL  REDEMPTION BY THE
CORPORATION.

                                                (i)         Optional  Redemption
in 2000.  If the  holders  of Series B  Preferred  Stock  fail to  request
redemption  of their shares of Series B Preferred  Stock  within the  ninety-two
(92)  day  period  provided  in  Section  C.3(a)(i)  hereof  for  such  optional
redemption,  and if such shares have not otherwise  been  converted to shares of
Class C Common Stock,  then the Corporation  may, upon at least thirty (30) days
prior  notice  delivered  at any time after the  expiration  of such  applicable
period (a Series B "Redemption Date"), redeem all, but not less than all, of the
outstanding  shares of Series B Preferred Stock at redemption price per share of
Series B  Preferred  Stock  equal to the  greater of (i) the then  "fair  market
value"  (calculated,  if the Corporation and the Series B Preferred  Stockholder
are unable to agree,  according to the procedures set forth in Section  3(d)(ix)
below) of such share,  including  for purposes of  calculating  such fair market
value,  the sum of all  accumulated  and unpaid  interest and  dividends on such
share of Series B  Preferred  Stock,  whether  or not such  dividends  have been
declared by the Corporation to the date such share is actually redeemed, or (ii)
the sum of the issue  price of such share plus an amount  equal to the amount of
all  accumulated  and unpaid  dividends  and  interest on such share of Series B
Preferred  Stock,  whether  or not such  dividends  have  been  declared  by the
Corporation to the date such share is actually redeemed.

                                                (ii)        Redemption  Pursuant
to  Securities  Purchase  Agreement.  The  Corporation  may redeem the then
issued and  outstanding  shares of Series B Preferred  Stock  pursuant to and
according to the terms and  provisions  of Section  5.3(e) of the  Securities
Purchase Agreement.


<PAGE>


                                     (D)        GENERAL PROVISIONS FOR
REDEMPTIONS.

                                                 (i)        Series B REDEMPTION
PRICE.  Each amount payable by the  Corporation  pursuant to Section C.3(a)
through (c) hereof respectively, is referred to as the "Series B Redemption
Price".

                                    (ii)        EFFECT OF  REDEMPTION.
Provision  for  payment  of the  Series B  Redemption  Price for  shares of
Series B Preferred  Stock having been made by the  Corporation,  and for so long
as there shall  be no  default  in the  payment  of  deferred  portions  of the
Series B Redemption Price, then (A) the shares of Series B Preferred Stock
designated for redemption in any notice shall not be entitled to any dividends
accruing  after the specified Redemption Date, and (B) on such Redemption Date
all rights of the respective  holders of such shares, as stockholders of the
Corporation by reason of the ownership of such shares of Series B Preferred
Stock, shall cease, except the right to receive the Redemption Price upon
presentation and surrender of the respective certificates representing such
shares.


                                    (iii)       DEFERRED PAYMENT FOR CERTAIN
APPROVED SERIES B PREFERRED STOCKHOLDER MAJOR DECISIONS.  On any Series B
Redemption Date resulting from the failure of the holders of Series B Preferred
Stock to approve (A) a sale of all or substantially all of the assets of the
Corporation  whether by asset or stock sale,  or otherwise  for  consideration
other than all cash or (B)  conveyance, transfer,  or lease by the Corporation
of all or any substantial  portion of its assets to any person or entity,  or
(C) a consolidation or merger referred to in Section  C.1(e)(1)(G)  above, the
Corporation  may, at its election,  in lieu of making  payment  in  full  in
cash,  prior  to the  consummation  of  any  such transaction,  pay to each
holder of shares of Series B Preferred Stock an amount in cash equal to one-half
(1/2) of the total Series B Redemption  Price, and may issue a promissory  note
of the Corporation in an amount equal to the balance of such Series B Redemption
Price;  provided however, that in the case of (A) above the  Corporation  shall
be  obligated  to pay to the  holders  of the  Series B Preferred  Stock an
additional pro rata amount of cash (and shall be entitled to reduce the
principal amount of any note referred to in (iv) below), if an to the extent it
receives any cash as a result of such a transaction.


                                    (iv)        PROMISSORY NOTE. Any promissory
note referred to in subparagraph (iii),  above, shall be payable in two (2)
equal annual  installments, commencing on the one (1) year anniversary  of the
Series B Redemption  Date,  of principal and interest and such  interest shall
accrue at the then prime rate (the "Prime  Rate") of the Corporation's  primary
banking institution  (or,  if there be no such institution,  the prime rate of
interest as  published in the Wall Street Journal, from time to time) plus one
hundred (100) basis points.  The obligations of the Corporation to make payment
under  such note shall be secured  by a perfected  security  interest in the
Corporation's  accounts receivable  (not  more than 90 days' due at the date of
perfection) with an aggregate value of not less that 120% of all amounts payable
under  such note from  time to time,  which recurring  interest  lien  shall be
subordinated only with respect to payments and priority to any lien(s)  granted
to  any of the  Corporation's  lending financial  institutions, incurred  in
accordance with these designations.


<PAGE>


                                    (v)         RETIREMENT OF SHARES.  Shares of
Series B Preferred  Stock that have been  redeemed,  purchased or otherwise
acquired by the Corporation shall be retired and may not be reissued.

                                    (vi)        SUBORDINATION  OF SERIES B
REDEMPTION  PRICE.  If, at the time the Series B  Redemption  Price is payable
to the holders of the Series B Preferred  Stock,  the Series A Redemption  Price
is also  payable to the  holders of the  Series A  Preferred  Stock or the
Series A Preferred  Stock has been  designated  for  redemption  pursuant to the
terms of Section B.3, no payment shall be made to the holders of Series B
Preferred Stock in  respect  of the  Series B  Redemption  Price  unless  and
until the Series A Redemption  Price  shall  have been paid in full to the
holders of the Series A Preferred Stock.

                                                 (vii)      EFFECT OF LEGAL
RESTRICTIONS ON PAYMENT.  If the Redemption Price for any such shares cannot be
paid in full  because  the  Corporation  is  prohibited  by law from making such
payment,  then  those  funds  that  are  legally  available  will be used to pay
(ratably if  necessary)  accrued but unpaid  interest,  then  accrued but unpaid
dividends,  and then to redeem the maximum possible number of shares of Series B
Preferred Stock ratably among the holders thereof  determined by multiplying the
total  number  of  shares of Series B  Preferred  Stock to be  redeemed  times a
fraction,  the  numerator of which shall be the total number of such shares then
held by each such holder and the  denominator of which shall be the total number
of such shares  then  outstanding.  The shares of Series B  Preferred  Stock not
redeemed shall remain  outstanding and be entitled to all rights and preferences
provided herein; provided, however, at any time thereafter when additional funds
of the  Corporation  are legally  available for the redemption of such shares of
Series B  Preferred  Stock,  such  funds  will be  used,  at the end of the next
succeeding fiscal quarter, to redeem the balance of such shares, or such portion
thereof  for which  funds are then  legally  available.  If fewer than the total
number of shares of Series B Preferred Stock  represented by any certificate are
redeemed, a new certificate representing the number of unredeemed shares will be
issued to the holder  thereof  without cost to such holder within three business
days after  surrender of the  certificate  representing  the redeemed  shares of
Series B Preferred Stock.

                                    (viii)      RESTRICTIONS  ON CORPORATE
ACTIONS.  If the Corporation for any reason fails to redeem any shares of Series
B  Preferred  Stock  in  accordance  with  this  Section  C.3 on or prior to the
Redemption Date specified herein, then, notwithstanding anything to the contrary
contained in these Articles of Incorporation,  the Corporation may not incur any
Indebtedness (unless the proceeds of such incurrence of Indebtedness are used to
make all overdue redemption payments in respect of the Series B Preferred Stock,

<PAGE>

including  payments of accrued but unpaid  dividends  or  interest)  without the
prior  written  consent of the  holders of the Series B Preferred  Stock  voting
separately as a class;  provided,  however, that, subject to the restriction set
forth  in  Section  C.1(c)(i),  if  such  restriction  is  then  in  force,  the
Corporation  may incur  Indebtedness  without the aforesaid  approval if (A) the
proceeds  of such  borrowing  are  used to pay  obligations  of the  Corporation
arising in the ordinary  course of business as they become due and  payable,  or
otherwise  to maintain the  operations  of the  Corporation  at the then current
level  and not to  expand  the  operation  of the  Corporation  in any  material
respect,  whether  through  expansion or  enhancement  of, or  addition,  to the
Corporation's then current  activities,  facilities,  equipment or other capital
assets, or otherwise,  (B) the Corporation provides prior written notice of such
borrowing to all holders of Series B Preferred Stock, which notice shall include
a statement  of the  intended  use of the  proceeds of such  borrowing,  and (C)
promptly upon request  therefor,  the Corporation shall provide to any holder of
Series B  Preferred  Stock a  certificate  signed  by the  President  and  Chief
Financial Officer of the Corporation  certifying as to the allocation and use of
the proceeds of any such borrowing.

                                                 (ix)       APPRAISAL.  Within
fourteen (14) days of any written request of any holder of shares of Series B
Preferred  Stock from time to time, the fair  market value of the Series B
Preferred  Stock shall  be determined  by an appraiser  or appraisers shall
according to the terms and procedures of Section B.3(d)(viii), except that all
references  shall be to Series B Preferred  Stock and Stockholders  rather than
Series A Preferred Stock and Stockholders.

                                                 (x)        MULTIPLE  HOLDERS OF
SERIES B PREFERRED  STOCK.  If the Series B Preferred  Stock is at any time held
by more than one person or entity,  the request for redemption  pursuant to this
Section C.3 by the holders of at least fifty-one  percent (51%) of the then
issued and outstanding  shares of Series B Preferred Stock shall  constitute the
request for redemption by the holders of all of the then issued and  outstanding
shares of Series B  Preferred  Stock and all such  holders of Series B Preferred
Stock shall  redeem their  shares of Series B Preferred  Stock  pursuant to this
Section  C.3 upon the  receipt  of notice  from  holders  of at least  fifty-one
percent  (51%) of the then issued and  outstanding  shares of Series B Preferred
Stock.

                         4.         CONVERSION RIGHTS.

                                     (a)        OPTIONAL CONVERSION BY HOLDER.

                                                (i)         General  Provisions.
All, but not less than all, of the issued and outstanding shares of Series B
Preferred Stock shall be convertible, without the payment of any additional
consideration, into shares of Class C Common Stock,  at the option of the
holders of the shares of Series B Preferred  Stock,  at any time prior to 5:00
P.M.  (EST) on FEBRUARY 24, 2000; provided,  however,  that if such conversion
occurs at any time during the 60 day period  referred to in Section  3(a)(ii)
(other than as the result of the adoption of a Business  Plan as set forth in
Section  1(e)(i)(A)  (above) or pursuant to Section  3(a)(iii) above,  after the


<PAGE>


Corporation  elects to take any action constituting a Series B Preferred
Stockholder Major Decision without the approval of the holders of the Series B
Preferred  Stock,  such conversion shall not be deemed to be an "optional
conversion" governed by the provisions of this Section  4(a),  but shall be
governed by the  provisions  relating to "Automatic Conversions"  set forth in
Section  4(b)  below.  Each  such  share of Series B Preferred  Stock  shall be
convertible  at such  time into one  fully-paid  and nonassessable  share of
Class C Common Stock,  subject to adjustment as provided in Section C.4.(e)
below (the "Series B Conversion Rate"). The holders of shares of Series B
Preferred Stock requesting conversion of shares into shares of Class C Common
Stock shall send a written notice to the Corporation,  at the principal office
of the  Corporation,  requesting such  conversion.  The holders shall, as soon
thereafter as practicable, deliver the certificates therefor, duly endorsed for
transfer,  at the principal  office of the Corporation or any transfer agent for
the Series B Preferred Stock. The Corporation  shall, as soon as practicable
thereafter,  issue and deliver to the holders a certificate or certificates  for
the number of such shares of Class C Common Stock to which the holders  shall be
entitled,  a check  payable to the  holders in the amount of any cash in lieu of
issuance of any fractional share, and the amount of any cumulative dividends and
interest accrued but unpaid (unless,  and to the extent,  the Corporation elects
to issue additional shares of Class C Common Stock in lieu of such dividends and
interest  pursuant to Section  C.4(d)) on such shares.  The conversion  shall be
deemed to have been made immediately  prior to the close of business on the date
of receipt of the notice.  The persons entitled to receive the shares of Class C
Common Stock issuable upon such conversion  shall be treated for all purposes as
the  record  holder or holders  of such  shares of Class C Common  Stock on such
date, and the shares of Series B Preferred Stock converted shall  immediately be
canceled and may not be reissued.

                                                 (ii)       Multiple  Holders of
Series B Preferred  Stock.  If the Series B Preferred  Stock is at any time held
by more than one person or entity,  the request for conversion  pursuant to this
Section C.4 by the holders of at least fifty-one  percent (51%) of the then
issued and outstanding  shares of Series B Preferred Stock shall  constitute the
request for conversion by the holders of all of the then issued and  outstanding
shares of Series B  Preferred  Stock and all such  holders of Series B Preferred
Stock shall  convert their shares of Series B Preferred  Stock  pursuant to this
Section  C.4 upon the  receipt  of notice  from  holders  of at least  fifty-one
percent  (51%) of the then issued and  outstanding  shares of Series B Preferred
Stock.

                        (b)         AUTOMATIC  CONVERSION.  If the holders of
Series B Preferred  Stock have not earlier  exercised  their rights to require
the  Corporation to redeem their shares of Series B Preferred  Stock pursuant to
the  provisions of Section  C.3.(a)  hereof,  all of the  outstanding  shares of
Series B Preferred Stock shall,  together with all other then outstanding shares
of the  Corporation's  preferred  stock or other  capital  stock with  rights to
convert  into  shares  of  Common  Stock,   be  converted  into  fully-paid  and


<PAGE>


nonassessable  shares of Class C Common  Stock at the Series B  Conversion  Rate
upon the  earlier  to  occur of the  closing  or other  consummation  of (i) any
Qualified Public Offering,  (ii) any  Non-Qualified  Public Offering,  (iii) any
combination,  consolidation or merger where the Corporation is not the survivor,
(iv) any sale,  exchange or other disposition of all or substantially all of the
Corporation's  assets,  whether by asset or stock sale or otherwise,  or (v) any
election  by the  holders  of Series B  Preferred  Stock to effect an  "Optional
Conversion" during any period during which the holders of the Series B Preferred
Stock may cause the  Corporation  to redeem  shares of their  Series B Preferred
Stock pursuant to the provisions of Section 3(a)(ii) or 3(a)(iii), above. In the
case of the  occurrence of any of (i) through (v) above,  all shares of Series B
Preferred  Stock  which have not been  converted  into  shares of Class C Common
Stock, shall be subject to mandatory  redemption by the Corporation  pursuant to
the  provisions  of Section  C.3.(iii)  hereof.  Shares of Class C Common  Stock
received  pursuant to this Section  4.(b) shall be subject to the  provisions of
Article  IV,  Section  A.4  in the  event  of a  Qualified  Public  Offering  or
Non-Qualified Public Offering,  and shall thereupon  immediately be reclassified
as shares of Class A Common  Stock.  At least  twenty  (20) days  prior  written
notice of the date fixed and place  designated for  conversion  shall be sent by
first class mail,  postage  prepaid,  to the address of each holder of shares of
Series B  Preferred  Stock as shown in the  records  of the  Corporation.  On or
before  the date  fixed  for  conversion,  each  holder  of  shares  of Series B
Preferred Stock shall surrender the certificates representing such shares to the
Corporation at the place designated in such notice and shall thereafter  receive
certificates  for the number of full shares of Common Stock to which such holder
is entitled. Until such time as holders of certificates theretofore representing
shares of  Series B  Preferred  Stock  have  surrendered  them for  exchange  as
provided  herein,  no  dividends  shall  be  paid  with  respect  to any  shares
represented by such  certificates and no payment for fractional  shares shall be
made.

                                     (c)        NO  FRACTIONAL  SHARES.  No
fractional  shares of Common Stock shall be issued upon  conversion of shares of
Series B Preferred Stock. In lieu of any fractional share, the Corporation shall
pay a cash adjustment in respect of such  fractional  interest equal to the fair
market value of such fractional interest as determined by the Board.

                                     (d)        PAYMENT OF  DIVIDENDS  AND
INTEREST.  At the time of the  conversion  of any  shares of Series B  Preferred
Stock,  whether  mandatory  or  optional,  and  after  payment  in  full  by the
Corporation  of all amounts of interest  and  cumulative  dividends  accrued but
unpaid with respect to Series A Preferred  Stock,  the Corporation  shall pay to
the holder of such  shares of Series B Preferred  Stock the sum of all  interest
and  cumulative  dividends  accrued  but unpaid  with  respect to such  Series B
Preferred  Stock,  whether or not such dividends shall have been declared by the
Corporation to the date of conversion.


<PAGE>


                                     (e)        ADJUSTMENTS;  ANTIDILUTION.  The
number of shares of Class C Common Stock  issuable  upon the  conversion of the
Series B Preferred  Stock shall be subject to  adjustment  from time to time
upon the happening of certain events as follows:

                                                 (i)        DIVIDENDS,  SPLITS.
If the Corporation  declares a dividend payable in its shares of its Common
Stock,  splits any of its Common Stock or combines any of its outstanding shares
of Common  Stock  into a smaller  number,  then the  number  of  fully-paid  and
nonassessable  shares of Class C Common  Stock into which each share of Series B
Preferred  Stock may be converted shall forthwith be adjusted by multiplying one
(1) by a  fraction  (A) the  numerator  of which  shall be the  total  number of
outstanding shares of Common Stock immediately after such dividend,  stock split
or  combination,  and (B) the  denominator of which shall be the total number of
outstanding  shares of Common Stock  immediately  prior to such dividend,  stock
split or combination.

                                                 (ii)       REORGANIZATION,
RECLASSIFICATION.  In  the  event  of  a  reorganization,  share  exchange,  or
reclassification,  other than a change in par value, or from par value to no par
value,  or  from  no par  value  to par  value  or a  transaction  described  in
subsection  (iii) or (iv) below,  each share of Series B Preferred  Stock shall,
after such reorganization,  share exchange or  reclassification,  be convertible
into the kind and number of shares of stock or other  securities  or property of
the  Corporation to which the holder of Series B Preferred Stock would have been
entitled  if the  holder  had  held  the  Class C  Common  Stock  issuable  upon
conversion  of  its  Series  B  Preferred  Stock   immediately   prior  to  such
reorganization,  share exchange,  or reclassification,  or to which the Series B
Preferred Stock is actually entitled, but not both.

                                                 (iii)      CONSOLIDATION,
MERGER,  SALE OF  ASSETS.  In the  event of a merger or  consolidation  or sale,
exchange or other  disposition of all, or substantially all of the Corporation's
assets,  to which the  Corporation is a party,  each share of Series B Preferred
Stock shall,  after such merger or  consolidation,  be convertible into the kind
and number of shares of stock and/or other securities, cash or other property to
which the  holder of such  share of Series B  Preferred  Stock  would  have been
entitled  if the  holder  had  held  the  Class C  Common  Stock  issuable  upon
conversion of its shares of Series B Preferred Stock  immediately  prior to such
consolidation  or merger or sale of assets,  or to which the Series B  Preferred
Stock is actually entitled, but not both.

                                                 (iv)       CERTAIN  ISSUANCES
OF ADDITIONAL  SHARES OF COMMON  STOCK.  If the  Corporation  shall issue any
additional  shares of Common Stock -- other than  securities to be issued (i) to
the public  pursuant to any Qualified  Public Offering or  Non-Qualified  Public
Offering,  (ii) to officers,  directors, or employees of the Corporation as part
of a stock option plan,  restricted  stock plan,  employee  stock purchase plan,
employment agreement, or other employee stock plan or agreement,  implemented by
the Board,  provided that the aggregate  numbers of such shares issued shall not
exceed ten percent (10%) of the fully diluted  capital stock of the  Corporation
calculated as of the time of the issuance,  (iii) to Management Stockholders and

<PAGE>

other  executive  employees of the  Corporation,  of an amount of Class A Common
Stock not in excess of the 25% Management Stock Amount,  (iv) upon conversion of
any shares of the Series A Preferred Stock, Series B Preferred Stock or Series C
Preferred  Stock or the  exercise of any  warrant to  purchase  shares of Common
Stock  held by the  holder of Series B  Preferred  Stock  pursuant  to the terms
hereof,  or (v) to the LP pursuant to Article XIV of the Practice  Participation
Agreement in respect of the issuance of Medical Holdings Limited  Partnership of
the Limited  Partner  Interests (or options to purchase such Interests) from and
after the time that more than  sixty-six  (66) but less than one  hundred  (100)
physicians  hold such  Limited  Partner  Interests  (or options to acquire  such
Interests) directly or indirectly through their professional corporations -- for
a consideration  per share of Common Stock less than the "conversion  price," as
adjusted or as previously  adjusted,  in effect on the date immediately prior to
such issuance,  then and in such event, such conversion price shall be adjusted,
concurrently  with such issuance,  to a price equal to the quotient  obtained by
DIVIDING:

                                                (1) an  amount  equal  to (x)
                        the sum of (A)  the  total  number  of  shares  of
                        Common  Stock  outstanding immediately prior to such
                        issuance or sale, plus (B) the total  number of shares
                        of Common  Stock  issuable  upon exercise  of all
                        options,  warrants  and  other  rights convertible or
                        exchangeable for, or evidencing the right to  purchase
                        shares  of,   Common  Stock   outstanding immediately
                        prior to such issuance or sale,  multiplied by (C) the
                        conversion price in effect  immediately prior to such
                        issuance or sale, plus (y) the consideration, if any,
                        received   or  deemed  to  be   received  by  the
                        Corporation upon such issuance or sale; BY

                                                (2) the sum of (A) the total
                        number of shares of Common Stock  outstanding
                        immediately  after such issuance or sale,  plus (B) the
                        total  number of shares of Common Stock  issuable upon
                        exercise of all options,  warrants and other rights
                        convertible  or  exchangeable  for, or evidencing the
                        right to purchase shares of, Common Stock outstanding
                        immediately after such issuance or sale.

For purposes of this Section C.4, the conversion price shall initially be $11.25
per share.

No  adjustment  of the  conversion  price  shall  be  made  under  this  Section
C.4.(e)(iv) upon the issuance of any additional  shares of Common Stock that are
issued pursuant to the exercise of any warrants,  options or other  subscription
or purchase  rights or pursuant to the  exercise of any  conversion  or exchange
rights in any convertible  securities if any such  adjustments  shall previously
have been made upon the issuance of any such  warrants,  options or other rights
or upon the issuance of any convertible  securities (or upon the issuance of any
warrants,  options or any rights  therefor)  pursuant to Sections  4(v) or 4(vi)
hereof.


<PAGE>


                                         (v)    ISSUANCE OF WARRANTS,  OPTIONS
OR OTHER  RIGHTS.  If the  Corporation  at any time shall issue any warrants,
options or other rights to subscribe  for or purchase any  additional  shares of
Common Stock and the price per share for which additional shares of Common Stock
may at any time  thereafter be issuable  pursuant to such  warrants,  options or
other  rights  shall be less  than the  conversion  price  per  share in  effect
immediately prior to such issuance,  then such issue shall be deemed on issuance
(as of the date of issue of such warrants, options or other rights) of the total
maximum  number of shares of Common Stock  issuable  pursuant to such  warrants,
options or other rights, and the conversion price shall thereupon be adjusted as
provided  in  Section  C.4.(e)(iv)  hereof  on  the  basis  that  the  aggregate
consideration  for the additional  shares of Common Stock  issuable  pursuant to
such warrants,  options or other rights,  plus the minimum  consideration  to be
received by the  Corporation  for the  issuance of  additional  shares of Common
Stock pursuant to such warrants,  options, or other rights shall be deemed to be
the consideration received by the Corporation for the issuance of such warrants,
options, or other rights.

                                                 (vi)       CERTAIN  ISSUANCES
OF  CONVERTIBLE  SECURITIES.   In  case  the  Corporation  shall  issue  any
securities  convertible  into Common Stock and the  consideration  per share for
which  such  additional  shares of Common  Stock may at any time  thereafter  be
issuable pursuant to the terms of such convertible securities shall be less than
the  conversion  price per share in effect  immediately  prior to such issuance,
then upon  such  issuance  of such  securities  the  conversion  price  shall be
adjusted  as provided  in Section  C.4.(e)(iv)  hereof on the basis that (i) the
maximum  number of  additional  shares of Common  Stock  necessary to effect the
conversion  or exchange of all such  convertible  securities  shall be deemed to
have been issued as of the date of issuance of such convertible securities,  and
(ii) the aggregate consideration for such maximum number of additional shares of
Common Stock plus the minimum consideration  received by the Corporation for the
issuance of such additional shares of Common Stock pursuant to the terms of such
convertible  securities shall be deemed to be the consideration  received by the
Corporation for the issuance of such  convertible  securities.  No adjustment of
the conversion  price shall be made under this  subsection  upon the issuance of
any  convertible  securities  which are issued  pursuant to the  exercise of any
warrants, options or other subscription or purchase rights therefor, if any such
adjustment  shall  previously have been made upon the issuance of such warrants,
options or other rights pursuant to Section C.4.(e)(v) hereof.

                                                 (vii)      ADJUSTMENT OF SERIES
B CONVERSION  RATE. Upon each adjustment of the conversion  price under the
provisions of this Section C.4.(e),  the conversion rate shall be adjusted to an
amount  determined by dividing  $11.25 by such adjusted  conversion  price.  For
example,  if, as a result of any of the  foregoing,  the  conversion  price were
reduced  to  $9.00,  each  share  of  Series B  Preferred  Stock  would  then be
convertible into 1.25 shares of Class C Common Stock.


<PAGE>


                                     (viii)     OTHER PROVISIONS  APPLICABLE TO
ADJUSTMENTS UNDER THIS SECTION.  The following provisions will be applicable to
the making of adjustments in conversion prices hereinabove provided in this
Section B.4.(e):

                                                (1)         COMPUTATION OF
CONSIDERATION.  To the extent that any additional  shares of Common Stock or any
convertible securities or any warrants, options or other rights to subscribe for
or purchase any additional shares of Common Stock or any convertible  securities
shall be  issued  for cash  consideration,  the  consideration  received  by the
Corporation  therefor  shall be deemed to be the amount of the cash  received by
the  Corporation  therefor,  or, if such  additional  shares of Common  Stock or
convertible  securities are offered by the  Corporation  for  subscription,  the
subscription   price.   To  the  extent  that  such  issuance  shall  be  for  a
consideration  other than cash, then the amount of such  consideration  shall be
deemed to be the fair value of such  consideration  at the time of such issuance
as  determined  in good  faith by the  Corporation's  Board  after  receipt of a
fairness opinion, appraisal or similar independent third-party advice determined
by a person or entity jointly selected by the Series B Preferred Directors,  the
Series A Preferred  Directors,  the Series C Preferred  Stock  Directors and the
other directors pursuant to procedures  substantially similar to those set forth
in Section 6 of the Stockholders Agreement. The consideration for any additional
shares of Common  Stock  issuable  pursuant  to any  warrants,  options or other
rights to subscribe for or purchase the same shall be the consideration received
by the Corporation for issuing such warrants,  options or other rights, plus the
additional  consideration  payable to the Corporation  upon the exercise of such
warrants,  options or other rights.  The consideration for any additional shares
of Common Stock  issuable  pursuant to the terms of any  convertible  securities
shall be the consideration  paid or payable to the Corporation in respect of the
subscription for or purchase of such convertible securities, plus the additional
consideration, if any, payable to the Corporation upon the exercise of the right
of  conversion  or  exchange  in  such  convertible  securities.  In case of the
issuance at any time of any  additional  shares of Common  Stock or  convertible
securities  in payment or  satisfaction  of any dividend upon any class of stock
preferred as to dividends in a fixed amount,  the Corporation shall be deemed to
have  received  for such  additional  shares  of  Common  Stock  or  convertible
securities  a  consideration  equal to the  amount of such  dividend  so paid or
satisfied.

                                                (2)         READJUSTMENT  OF
CONVERSION  PRICE.  Upon the expiration of the right to convert or exchange any
convertible  securities,  or upon  the  expiration  of any  rights,  options  or
warrants,  without  conversion,  exchange  or  exercise,  the  issuance of which
convertible  securities,  rights,  options or warrants effected an adjustment in
the conversion  price,  such conversion  price shall forthwith be readjusted and
thereafter  be the price  which it would  have been  (but  reflecting  any other
adjustments  in the  conversion  price made  pursuant to the  provisions of this
Section  C.4.(e)  after the  issuance of such  convertible  securities,  rights,
options or warrants) had the  adjustment of the  conversion  price made upon the
issuance or sale of such convertible  securities or issuance of rights,  options
or  warrants  been  made on the  basis of the  issuance  only of the  number  of


<PAGE>

additional shares of Common Stock actually issued upon conversion or exchange of
such  convertible  securities,  or upon the exercise of such rights,  options or
warrants,  and thereupon  only the number of  additional  shares of Common Stock
actually  so issued,  if any,  shall be deemed to have been  issued and only the
consideration  actually  received by the  Corporation  (computed as set forth in
subsection C.4.(e)(viii)(1) hereof) shall be deemed to have been received by the
Corporation.  If the purchase price provided for in any such rights,  options or
warrants,  or the additional  consideration (if any) payable upon the conversion
or exchange of any convertible securities,  or the rate at which any convertible
securities  are  convertible  into or  exchangeable  for shares of Common  Stock
changes at any time  (other  than under or by reason of  provisions  designed to
protect  against  dilution),  the conversion  price in effect at the time of the
change shall be adjusted to the conversion  price that would have been in effect
at such time had such rights, options,  warrants or convertible securities still
outstanding provided for such changed purchase price,  additional  consideration
or conversion rate, as the case may be, at the time initially granted, issued or
sold.

                                                (3)         OTHER ACTION
AFFECTING  COMMON STOCK.  If the Corporation  shall take any action  affecting
the outstanding  number of shares of Common Stock, other than an action
described in any of the foregoing  subsections 4(e)(i) to (vii) hereof,
inclusive,  which in the opinion of the  Corporation's  Board would have a
materially  adverse effect upon the rights of the holders of the Series B
Preferred  Stock,  the conversion price  shall be  adjusted  in such  manner
and at such  time as the  Board  may determine to be equitable in the
circumstances.

                                       (ix)     NOTICES OF ADJUSTMENTS.
Whenever the conversion rate and conversion  price is adjusted as herein
provided, an officer of the  Corporation  shall compute the adjusted  conversion
rate and conversion price in accordance with the foregoing provisions and shall
prepare a written  instrument  setting forth such adjusted  conversion rate and
conversion price and showing in detail the facts upon which such  adjustment is
based,  and such written instrument shall promptly be delivered to the record
holders of the Series B Preferred  Stock,  who shall approve such  conversion
rates and prices within 30 days of receipt.  If holders of Series B Preferred
Stock do not object in writing during such 30 day period, they shall be deemed
to have approved such conversion rates and prices for all purposes hereof.

                                     (f)     RESERVATION OF SHARES.  The Board
shall at all times reserve and keep available, out of its authorized but
unissued shares of Class C Common Stock, solely for the purpose of  effecting
the  conversion of the shares of Series B Preferred Stock,  the full  number of
shares of Class C Common  Stock  deliverable  by the Corporation  upon the
conversion of all shares of Series B Preferred  Stock from time to time
outstanding  and otherwise  issuable under rights granted from the Corporation
then existing.


<PAGE>


                                     (g)     NO IMPLIED MODIFICATION OF TERMS.
The provisions of this Section C.4. shall not give, or be deemed to give, the
Corporation the power or authority to issue any shares of its capital stock or
other  securities or to take any other action that it is expressly prohibited
from issuing by another provision hereof.

                         5.         LIQUIDATION RIGHTS.

                                     (a)        Upon any  liquidation,
dissolution or winding up of the affairs of the  Corporation,  whether
voluntary or involuntary,  the  holders of shares of the Series B  Preferred
Stock  shall be entitled  to  receive  out  of  the  assets  of the  Corporation
available  for distribution to  stockholders,  before any distribution or
payment shall be made in respect of the holders of shares of Common Stock or any
other class or series of  stock  ranking  junior  to the  Series  B  Preferred
Stock,  a  liquidating distribution  in an  amount  equal to the  greater  of
(i) the sum of the  "fair market  value" per share of Series B Preferred  Stock,
which  shall  include an amount per share equal to all  cumulative  dividends
and  interest  accrued but unpaid  thereon,  whether or not such  dividends  and
interest  shall have been declared by the Corporation, to the date fixed for
such distribution or payment; or (ii) the sum of the original  purchase  price
per share of Series B Preferred Stock plus an amount equal to all cumulative
dividends and interest accrued but unpaid  thereon to the date fixed for such
distribution  or payment;  provided, however,  in either  such  event the amount
of cash  payable by the  Corporation shall not exceed the amount of cash paid to
the  Corporation  by all  holders of such shares with respect to the purchase of
such shares,  including  the payment of any  interest  with  respect  thereto,
through  and  including  the  date of liquidation;  and provided further,
however,  that no liquidating  distribution shall be paid in  respect  of
Series B  Preferred  Stock  unless  and until all amounts due to holders of
Series A Preferred Stock as a liquidating distribution pursuant to Section
B.5(a) shall have been fully paid. The holders of shares of Series B  Preferred
Stock  shall not be  entitled  to  receive  any  additional distributive
amounts upon such  liquidation,  dissolution  or winding up of the affairs  of
the  Corporation   resulting  in  any  distribution  of  assets  to
stockholders.

                                     (b)        If, upon any such  liquidation,
dissolution or winding up of the affairs of the Corporation,  the assets of the
Corporation to  stockholders  shall be insufficient to permit the payment in
full to the holders of Series B Preferred Stock of the amounts to which they are
entitled,  then all of such available assets shall be distributed to the holders
of shares of Series B Preferred  Stock ratably in proportion to the  liquidation
payment  otherwise due under Section  C.5.(a) to each such holder and no amounts
shall be  distributed  in  respect of any other  share of  capital  stock of the
Corporation other than Series A Preferred Stock until all amounts  distributable
to holders of Series B Preferred Stock have been distributed.

                                     (c)        The purchase or redemption by
the Corporation of stock of any class,  in any manner  permitted by law, shall
not  for  the  purpose  of this  Section  C.5.  be  regarded  as a  liquidation,
dissolution  or winding up of the  Corporation.  Neither the  consolidation  nor
merger of the Corporation  with or into any other  corporation or  corporations,
nor the sale or  transfer  by the  Corporation  of all or any part of its assets
shall  be  deemed  to  be a  liquidation,  dissolution  or  winding  up  of  the
Corporation for the purpose of this Section C.5.


<PAGE>



                                     (d)        At least thirty (30) days prior
written  notice of any such  liquidation,  dissolution  or winding up of the
affairs of the Corporation stating a payment date, the amount of the liquidation
payments and the place where said liquidation  payments shall be payable,  shall
be sent by first  class  mail,  postage  prepaid,  to each  holder  of  Series B
Preferred Stock at his address as shown on the records of the Corporation.

                         6.         EVENTS OF NON-COMPLIANCE; NON-COMPLIANCE.

                                     (a)        DEFINITION.  "Event of
Non-Compliance"  shall mean, with respect to the Corporation,  the occurrence of
any of the events,  occurrences or circumstances  listed below;  provided,
however, that   any   such   event,   occurrence   or   circumstance   shall
constitute "Non-Compliance"  if, and only if, (i) in the case of any event,
occurrence  or circumstance  involving  the  non-payment  of moneys  (other than
dividend  and accrued  interest  payments due and payable to the holders of
Series B Preferred Stock),  within  thirty (30)  calendar  days  following
written  notice of such non-payment,  such moneys have not been paid by or on
behalf of the Corporation; and (ii) in the case of any event,  occurrence or
circumstance not involving the non-payment  of moneys,  substantial  efforts
have not been  commenced by or on behalf of the Corporation to cure such event,
occurrence, or circumstance within a reasonable time after notice thereof (but
in no event later than 30 days), and having  been so  commenced,  there  is a
failure  within a  reasonable  time to prosecute to completion  with diligence
and continuity the curing of such event, occurrence  or  circumstances,  or a
period  of more  than 90 days has  occurred without  such cure being  completed
to the  satisfaction  of the holders of the Series B Preferred Stockholders;
provided, further, however, that, for purposes of (i) and (ii)  above  the
occurrence  of any of the  events,  occurrences  or circumstances  described in
subparagraphs  (5), (6) (7), (8), (9) or (10), below shall  constitute
Non-Compliance  immediately  upon its  occurrence or upon the happening of such
event or  circumstances,  without any requirement of notice or passage of time
except as specifically set forth in such item:

                                                (1) any failure of the
Corporation to make any payment  required to be made by it to the holders of
Series B Preferred Stock hereunder when due;

                                                (2) any  material  default  by
the  Corporation  in the  payment  of any other  material  obligation  of the
Corporation to any holder of Series B Preferred  Stock;  including  specifically
but without limitation payment obligations  pursuant to any contract,  agreement
or other  business  transaction  entered  into between the  Corporation  and any
holder of Series B Preferred Stock in the ordinary course of the Business of the
Corporation.

<PAGE>

                                                (3)         the  Corporation
otherwise  breaches or  otherwise  fails to perform or observe in any material
respect  any  material  covenant  or  agreement  set  forth  herein  or  in  the
Registration Rights Agreement between the Corporation and the initial holders of
the Series B  Preferred  Stock  dated on or about  November  30,  1995 or in any
Collateral Agreement (as defined therein).

                                                (4)         beginning  on  April
1,  2000,  whenever  dividends  accruing  after  such date on the  Series B
Preferred  Stock shall be in arrears in an aggregate  amount equal to at least 4
quarterly dividends thereon;

                                                (5)         institution  by the
Corporation  of  proceedings  of any nature under any laws or  regulations,
whether now existing or subsequently enacted or amended, for the relief of
debtors wherein the Corporation is seeking relief as debtor;

                                                (6)         a general assignment
by the Corporation for the benefit of creditors;

                                                (7)         the  institution by
the Corporation of a case or other  proceeding  under any section or chapter of
the Federal Bankruptcy Code as now existing or hereafter amended or becoming
effective;

                                                (8)         the  institution
against the  Corporation  of a case or other  proceeding  under any section or
chapter of the Federal  Bankruptcy Code as now existing or hereafter  amended or
becoming  effective,  which  proceeding is not  dismissed,  stayed or discharged
within a period of ninety (90) calendar days after the filing thereto;

                                                (9)         the  appointment of
a receiving,  custodian,  trustee or like officer to take  possession of the
assets of the Corporation, if the tendency of said receivership would reasonably
tend to have a materially adverse effect upon the

<PAGE>


performance by the Corporation of its obligations hereunder, which receivership
imposition;
                                               (10)        admission by the
Corporation in writing of its inability to pay its debts as they mature or the
Corporation is adjudicated as insolvent;

                                                (11)        attachment,
execution  or  other  judicial  seizure  of  all  or any  substantial  part  of
the Corporation's  assets,  such  attachment,  execution  or  seizure  in  any
case remaining undismissed or undischarged for a period of fifteen (15) calendar
days after the levy thereof;  provided,  however, that said attachment,
execution or seizure  shall  not  constitute  an Event  of  Non-Compliance
hereunder  if the Corporation  posts a bond  sufficient in amount to satisfy or
secure the payment of such claim or judgment within sixty (60) calendar days
after the levy thereof and  the  Corporation's  assets  are  thereby  released
from  the  lien of such attachment;

                                                (12)        one or more
judgments or decrees is entered against the  Corporation or any of its
Subsidiaries involving  in the  aggregate a  liability  (to the extent not paid
or covered by current insurance) of the greater of (A) $100,000 with respect to
1995; $200,000 with respect to 1996;  $300,000  with respect to 1997;  $400,000
with respect to 1998; and $500,000 with respect to each year thereafter or (B)
ten percent (10%) of the net operating  earnings of the Corporation for the
immediately  preceding fiscal year, as  calculated  by the  independent
certified  public  accountants employed by the  Corporation,  and all such
judgments  or decrees have not been vacated,  discharged,  stayed or bonded
pending  appeal within 60 days from the entry thereof;

                                                (13)        defaults shall have
occurred under any agreements,  indentures,  or instruments  under which the
Corporation  then has any  outstanding  Indebtedness in excess of the greater of
(A) $100,000 with respect to 1995;  $200,000 with respect to 1996; $300,000 with
respect to 1997;  $400,000  with respect to 1998;  and $500,000  with respect to
each year  thereafter or (B) ten percent (10%) of the net operating  earnings of
the Corporation for the immediately  preceding fiscal year, as calculated by the
independent  certified  public  accountants  employed by the  Corporation in the
aggregate and if not already  matured at its final  maturity in accordance  with
its terms, such Indebtedness shall have been accelerated; and/or

                                                (14) any holder of  Indebtedness
of the  Corporation  equal to the greater of (A) $100,000  with respect to 1995;
$200,000 with respect to 1996;  $300,000  with respect to 1997;  $400,000 with
respect to 1998;  and $500,000 with respect to each year  thereafter or (B) or
ten percent (10%) of the net operating  earnings of the  Corporation  for the
immediately  preceding  fiscal year, as calculated by the independent  certified
public  accountants  employed  by the  Corporation,  after a default  under such
Indebtedness shall commence proceedings, or take any action (including by way of
set-off) to retain in  satisfaction of such  Indebtedness or to collect,  seize,
dispose  of,  or apply  in  satisfaction  of such  Indebtedness,  assets  of the
Corporation  having a fair market value in excess of the greater of (A) $100,000

<PAGE>

with respect to 1995;  $200,000  with respect to 1996;  $300,000 with respect to
1997;  $400,000  with respect to 1998;  and  $500,000  with respect to each year
thereafter  or (B) ten  percent  (10%)  of the  net  operating  earnings  of the
Corporation  for the  immediately  preceding  fiscal year,  as calculated by the
independent   certified   public   accountants   employed  by  the  Corporation,
individually or in the aggregate (including funds on deposit or held pursuant to
lock-box and other similar arrangements).

                        D.          SERIES C PREFERRED STOCK.

                                                 1.         VOTING RIGHTS.

                                                 (a) General  Provisions.
Holders of Series C Preferred  Stock shall be entitled to notice of each
meeting of all of the Corporation's stockholders, but shall not be entitled to
notice of special or other  meetings of any class of Common Stock or of Series A
Preferred Stock or Series B Preferred  Stock.  The holders of shares of Series C
Preferred Stock  shall  vote with the  holders  of shares  of  Common  Stock and
Series A Preferred Stock and Series B Preferred Stock on all matters  submitted
to a vote of  stockholders  and not as a  separate  series or class,  except as
otherwise provided herein. Except as otherwise provided herein, on all matters
to be voted on by the Corporation's  stockholders,  every holder of Series C
Preferred Stock shall be entitled to cast, in person or by proxy,  that number
of votes equal to the full  number of shares of Class C Common  Stock  into
which  such  holder's Series C Preferred Stock is then convertible.

                                                 (b) Series C Preferred  Stock
Directors.  The holders of shares of Series C Preferred  Stock,  voting as a
single class,  shall be entitled to elect two (2)  directors of the  Corporation
and such directors shall, under the Corporation's  By-laws, be entitled to serve
on the Executive  Committee of the  Corporation's  Board of Directors until such
time as there is a Qualified Public Offering (such directors,  being referred to
as the  "Series C  Preferred  Stock  Directors").  Where the holders of Series C
Preferred  Stock vote as a class,  the  affirmative  vote of a  majority  of the
shares  of  Series C  Preferred  Stock  represented  in  person or by proxy at a
meeting  at which a quorum  of  Series C  Preferred  Stock is  present  shall be
sufficient to approve any matter with respect to which said holders are entitled
to vote;  provided,  however,  that the  affirmative  vote of a plurality of all
votes  cast in person or by proxy by the  holders  of Series C  Preferred  Stock
shall be sufficient to elect a Series C Preferred Stock Director. The holders of
Series C  Preferred  Stock,  at any  annual  meeting or upon a call of a special
meeting  of  holders  of Series C  Preferred  Stock by  holders of not less than
twenty-five  percent  (25%) of the  shares  of  Series C  Preferred  Stock  then
outstanding,  may remove any Series C Preferred  Stock  Director at any time and
from time to time,  voting as a single class, by the affirmative  vote of eighty
percent  (80%) of all votes  entitled to be cast for the  election of a Series C
Preferred  Stock  Director,  and may  elect a  successor  to fill any  resulting
vacancies  for the  remainder  of the  term of such  Series  C  Preferred  Stock


<PAGE>


Director.  If any Series C Preferred Stock Director shall cease to be a director
for any reason (including death,  resignation,  removal or any other cause), the
vacancy  shall be filled by a vote of the  remaining  Series C  Preferred  Stock
Director or, if no Series C Preferred Stock Director  remains,  by a vote of the
holders of Series C  Preferred  Stock  (unless,  with  respect to  removal,  the
holders of Series C Preferred Stock have elected a successor  Series C Preferred
Stock Director pursuant to the provisions hereof). If there is no such remaining
director, then upon a call of a special meeting of holders of Series C Preferred
Stock,  by any such  holder,  the  vacancy  shall be  filled  by the vote of the
holders of Series C Preferred Stock, voting as a single class.

                                                 (c)  Actions  Requiring  Votes
of the  Series C  Preferred  Stock  Director  or  Stockholder.  Without  the
affirmative  vote of each of the Series C Preferred Stock Directors (or the sole
Series C Preferred Stock Director,  when  applicable) or the holders of Series C
Preferred Stock, the Corporation shall not:

                                                (i)         incur or  permit
any of its  Subsidiaries  (as  defined  in  Section  B.1(d)(v))  to incur  any
Indebtedness  (as  defined  in  Section  B.1(d)(i))  as a result  of  which  the
outstanding Indebtedness of the Corporation would on a consolidated basis exceed
One Million Dollars  ($1,000,000) in the aggregate;  other than (A) Indebtedness
that is  subordinated  in right of dividends,  redemption and liquidation to the
Series  C  Preferred   Stock  and/or  (B)   Indebtedness   contemplated  in  the
Corporation's  Operating Plan (the "Operating  Plan") included in Section 3.6(b)
of the Disclosure  Schedule attached to the Stock Purchase Agreement dated as of
September  4,  1996 by and  between  the  Company  and the  Series  C  Preferred
Stockholder (the "Stock Purchase Agreement") and attached thereto, as reduced by
the  amount  of  the  Series  C  Preferred   Stockholder's   investment  in  the
Corporation,  which reduction shall be in an amount up to Twenty Million Dollars
($20,000,000); or

                                                (ii)       issue any shares of
its  capital  stock with  liquidation,  redemption  or  dividend rights senior
to (or PARI PASSU with) the liquidation, redemption or dividend rights of the
Series C Preferred Stock; or

                                                (iii)       effect any amendment
to these Amended and Restated  Articles of  Incorporation or to the By-Laws of
the Corporation that adversely affects the holders of the Series C Preferred
Stock or the Class C Common Stock; or

                                                (iv)        pay any dividend
with respect to the Series A Preferred  Stock or the Series B Preferred  Stock
prior to September 1, 1998 unless paid in connection with a redemption; or

                                                (v)         obligate the
Corporation to do any of the foregoing.

For purposes of this Section D.1(c), the holders of the Series C Preferred Stock
may take action to enforce  their  rights  under this  Section  D.1(c) at a duly
called meeting of the Corporation's  stockholders;  provided,  however, that the
exercise  of such  rights  shall  not  require a  meeting  of the  Corporation's
stockholders.


<PAGE>


                                    (d)         Definitions.  For  purposes  of
this  Section  D, the  definitions  set forth in  Section  B.1.(d)  shall be
applicable except that:

                                                (i)         In Section
B.1(d)(i)(G)(x),  the phrase  "Series C Preferred  Stock" shall be  substituted
for "Series A Preferred Stock;"

                                                (ii)        "QUALIFIED  PUBLIC
OFFERING" shall mean any public  underwritten  offering of the  Corporation's
Common Stock  pursuant to an  effective  registration  statement  filed with the
Securities  and Exchange  Commission  pursuant to the Securities Act of 1933, as
amended  (the  "1933  Act")  based  upon a total  market  capitalization  of the
Corporation,  at the time of such  offering,  of at least  100  Million  Dollars
($100,000,000),  from which the Company  receives  net proceeds of not less than
Twenty-Five Million Dollars ($25,000,000).

                                    (e)         Method of  Approval.  Whenever
any  action  described  herein  requires  the  action of holders of Series C
Preferred Stock,  such action shall be deemed to have occurred upon the approval
of holders of a majority of the then issued and  outstanding  shares of Series C
Preferred  Stock at a duly convened  meeting of such  stockholders,  or by their
written  consent  (without  necessity for a meeting),  and the  Corporation,  in
undertaking  any action with respect to such holders,  shall be entitled to rely
upon a certificate signed by such holders to that effect.

                        2.          DIVIDENDS.

                                                 (a)        Accrual  of
Dividends.  Subject  to the  provisions  of  Sections  2(b)  and 2(c)  below,
cash dividends  shall accrue on shares of Series C Preferred Stock issued
pursuant to the Stock  Purchase  Agreement at the rate of One Dollar and Forty
Cents ($1.40) per share per annum and on shares of Series C Preferred Stock
issued pursuant to the Option Agreement at the rate of One Dollar and Sixty
Cents ($1.60) per share per annum,  beginning  on the date of issuance  of such
shares  (whether or not earned or declared or payment is legally  available
therefor)  and shall accrue interest at the rate of 8% (based upon a 365-day
year)  compounded  quarterly on all such unpaid dividend amounts.

                                                  (b) Payment of  Dividends.
Unless  canceled  pursuant to the  provisions  of Section 2(c) below,  dividends
and interest accrued on or with respect to accrual dates shall be payable
(either as part of a Series C Redemption  Price (as defined below) or
liquidation  payment, or otherwise)  only after all dividends and interest
accrued on or with respect to the Series A  Preferred Stock and Series B
Preferred  Stock have been fully paid and only upon (i) the liquidation of the
Corporation as herein provided, or (ii) the  redemption or conversion of such
shares of Series C Preferred  Stock, and if not paid upon liquidation,
redemption or conversion,  the amount of all such  accrued dividends  and


<PAGE>

interest  payments  shall  become  an  unsecured obligation  of the Corporation,
bearing  interest at the per annum rate of 100 basis points over The Wall Street
Journal Prime Rate as of the last business day prior to such liquidation,
redemption or conversion and such interest shall be payable on the first day of
each month of January,  April,  July and October if, at the time of payment (i)
all  dividends  and  interest  accrued on or declared with respect to the Series
A Preferred  Stock and the Series B Preferred  Stock have been fully  paid,  and
(ii) funds for the full  payment of such  quarterly dividend on all shares of
Series C Preferred Stock then  outstanding are legally available therefor under
the laws of the State of Maryland as then in effect.

                                                 (c)        Cancellation of
Accrued  Dividends.  All accrued dividends and unpaid interest shall be canceled
and no longer be payable in the event the Company consummates a Qualified Public
Offering on or before  August 30, 1998 at a price per share of not less than the
weighted average price paid or to be paid by the Series C Preferred  Stockholder
for all shares of Series C Preferred  Stock then  outstanding  or subject to the
Option, plus all accrued but unpaid dividends and interest thereon.

                                                 (d)        Reduction  of
Capital.  If at any time when a dividend  on shares of Series C  Preferred
Stock would  otherwise be payable (i) funds for the full payment of such
dividend are not then legally  available  therefor under the laws of the State
of Maryland as then  in  effect  as  applied  to  the  then  effective
capitalization  of  the Corporation,  and (ii) funds for the payment of such
dividend  would be legally available  if the stated  capital  accounts of the
Corporation  were reduced or capital  surplus was revalued,  then, in such
event,  the Board shall reduce the stated capital at least to the extent
necessary to declare and pay such dividend or cause a  revaluation  of  capital
surplus  if such  reduction  of capital or valuation  of  surplus  would be
permissible  under  the  laws of the  State of Maryland as then in effect and
unless the exercise of the Board's fiduciary duty prevents such reduction.

                                                 (e)        Limitation  on other
Dividends;  Payments.  So long as any shares of Series C  Preferred  Stock
remain  outstanding,  (i) no dividends shall be declared or paid upon, nor shall
any  dividend or other  distribution  be made with respect to, any shares of any
other  class or series of stock or equity  interest  of the  Corporation  or any
Subsidiary, other than the Series A Preferred Stock or Series B Preferred Stock,
without the consent of each of the Series C Preferred  Stock  Directors  (or the
sole Series C Preferred Stock Director, when applicable),  and (ii) no shares of
any class of stock or equity interest of the Corporation or any Subsidiary other
than the shares of Series C Preferred Stock, Series B Preferred Stock and Series
A Preferred Stock shall be redeemed, retired, purchased or otherwise acquired by
the Corporation, except purchases of the Corporation's interests in a Subsidiary
at the time of its organization.  Notwithstanding the foregoing, the Corporation
may (i) effect  Permitted  Redemptions  pursuant  to Section  A.5;  and (ii) may
redeem  shares of  capital  stock of or  equity  interests  in any  wholly-owned
Subsidiary.


<PAGE>


                         3.         REDEMPTION.

                                                 (a)        OPTIONAL  REDEMPTION
BY  HOLDERS.  If,  without the  approval  of the Series C Preferred  Stock
Directors,   the  Corporation   elects  to  consummate  either  (1)  an  initial
underwritten  public  offering of the  Corporation's  equity  securities,  (2) a
merger, consolidation or similar combination transaction in which the Company is
not  the  survivor,  or  (3) a  sale,  transfer  or  other  disposition  by  the
Corporation of all or substantially all of the Corporation's assets,  whether by
asset or stock sale or otherwise, at a price per share equal to or less than the
weighted average price paid or to be paid by the Series C Preferred  Stockholder
for all shares of Series C Preferred  Stock then  outstanding  or subject to the
Option,  plus all accrued but unpaid  dividends and interest  thereon,  then the
Corporation  shall  give  notice  of such  election  to each  holder of Series C
Preferred  Stock at least 30 (30) days  prior to the date  such  action is to be
effective,  and the holders of Series C Preferred  Stock shall be  entitled,  by
delivery of a written notice to the  Corporation at the principal  office of the
Corporation  not less than twenty-one (21) days prior to the date such action is
to be effective, to request the Corporation to redeem, and the Corporation shall
redeem out of any funds legally available therefor,  all (but not less than all)
of the then issued and outstanding  shares of Series C Preferred Stock then held
by the  holders  requesting  redemption,  at an  amount  per  share of  Series C
Preferred  Stock  outstanding  equal to the  greater of (A) the then fair market
value of such share  (including,  for purposes of  calculating  such fair market
value,  the sum of all  accumulated  and unpaid  interest and  dividends on such
share of Series C  Preferred  Stock,  whether  or not such  dividends  have been
declared by the Corporation to the date such share is actually  redeemed) or (B)
the weighted  average price paid by the Series C Preferred  Stockholder for each
share of Series C Preferred Stock then outstanding,  plus all accrued but unpaid
dividends and interest thereon, whether or not such dividends have been declared
by the  Corporation to the date such share is actually  redeemed.  To the extent
that net cash  proceeds  are  received by the  Corporation  as the result of the
taking of such action,  (i) the  Corporation  shall pay any redemption  price in
cash to the holders of Series C Preferred  Stock,  such cash to be paid pro rata
among the holders of Series C Preferred Stock  requesting such redemption  (with
such redemption being a condition precedent to the Corporation's receipt of such
net proceeds) upon the occurrence of such action (a "Series C Redemption Date").
To the extent  that such net cash  proceeds  received  by the  Corporation  as a
result of taking such action are  insufficient to enable the Corporation to make
full payment in cash,  the  Corporation  may pay the balance due with respect to
the redemption of such shares within 180 days of such request.


                                     (b)        MANDATORY  REDEMPTION BY THE
CORPORATION.  Upon the occurrence of any Event of Non-Compliance (as defined in
Section D.6),  the  Corporation  shall redeem all, but not less than all, of the
shares of Series C  Preferred  Stock  then held by each  holder at an amount per
share of Series C Preferred  Stock  outstanding  equal to the greater of (A) the


<PAGE>


then fair market value of such share  (including,  for  purposes of  calculating
such fair market  value,  the sum of all  accumulated  and unpaid  interest  and
dividends  on such  share  of  Series C  Preferred  Stock,  whether  or not such
dividends  have been  declared  by the  Corporation  to the date  such  share is
actually  redeemed)  or (B) the  weighted  average  price  paid by the  Series C
Preferred   Stockholder  for  each  share  of  Series  C  Preferred  Stock  then
outstanding,  plus all accrued but unpaid dividends and interest thereon, within
ten (10) business days after the  occurrence  of such  Non-Compliance.  Any such
redemption  shall not be in lieu of or in any way limit any other  rights  which
such holders may have (at law or in equity) in connection  with the event giving
rise to their right of redemption.

                                     (c)        GENERAL PROVISIONS FOR
REDEMPTIONS.

                                                 (i)        Series C  REDEMPTION
PRICE.  Each  amount  payable by the  Corporation  pursuant to Section D.3
hereof is referred to as the "Series C Redemption Price".

                                                 (ii)        EFFECT OF
REDEMPTION.  Provision  for  payment  of the  Series C  Redemption  Price for
shares of Series C Preferred  Stock having been made by the  Corporation,  and
for so long as there shall  be no  default  in the  payment  of  deferred
portions  of the  Series C Redemption Price, then (A) the shares of Series C
Preferred Stock designated for redemption in any notice shall not be entitled to
any dividends  accruing  after the specified Redemption Date, and (B) on such
Redemption Date all rights of the respective  holders of such shares, as
stockholders of the Corporation by reason of the ownership of such shares of
Series C Preferred Stock, shall cease, except the right to receive the
Redemption Price upon presentation and surrender of the respective certificates
representing such shares.

                                                 (iii)      RETIREMENT OF
SHARES. Shares of Series C Preferred  Stock that have been  redeemed,  purchased
or otherwise acquired by the Corporation shall be retired and may not be
reissued.

                                                 (iv)        SUBORDINATION  OF
SERIES C REDEMPTION  PRICE.  If, at the time the Series C  Redemption  Price is
payable to the  holders of the Series C  Preferred  Stock,  the Series A
Redemption Price and/or Series B Redemption  Price is also payable to the
holders of the Series A Preferred  Stock or Series B Preferred  Stock or the
Series A Preferred Stock or Series B Preferred  Stock has been  designated  for
redemption pursuant to the terms  hereof,  no payment  shall be made to the
holders of Series C  Preferred Stock in respect of the Series C Redemption Price
unless and until the Series A Redemption  Price and Series B Redemption Price
shall have been paid in full to the holders of the Series A Preferred Stock and
Series B Preferred Stock.

                                                 (v)        EFFECT OF LEGAL
RESTRICTIONS ON PAYMENT.  If the Redemption Price for any such shares cannot be
paid in full  because  the  Corporation  is  prohibited  by law from making such
payment,  then  those  funds  that  are  legally  available  will be used to pay


<PAGE>

(ratably if  necessary)  accrued but unpaid  interest,  then  accrued but unpaid
dividends,  and then to redeem the maximum possible number of shares of Series C
Preferred Stock ratably among the holders thereof  determined by multiplying the
total  number  of  shares of Series C  Preferred  Stock to be  redeemed  times a
fraction,  the  numerator of which shall be the total number of such shares then
held by each such holder and the  denominator of which shall be the total number
of such shares  then  outstanding.  The shares of Series C  Preferred  Stock not
redeemed shall remain  outstanding and be entitled to all rights and preferences
provided herein; provided, however, at any time thereafter when additional funds
of the  Corporation  are legally  available for the redemption of such shares of
Series C  Preferred  Stock,  such  funds  will be  used,  at the end of the next
succeeding fiscal quarter, to redeem the balance of such shares, or such portion
thereof  for which  funds are then  legally  available.  If fewer than the total
number of shares of Series C Preferred Stock  represented by any certificate are
redeemed, a new certificate representing the number of unredeemed shares will be
issued to the holder  thereof  without cost to such holder within three business
days after  surrender of the  certificate  representing  the redeemed  shares of
Series C Preferred Stock.

                                                 (vi)        RESTRICTIONS  ON
CORPORATE ACTIONS.  If the Corporation for any reason fails to redeem any shares
of Series C  Preferred  Stock  in  accordance  with  this  Section  D.3 on or
prior to the Redemption Date specified herein, then, notwithstanding anything to
the contrary contained in these Articles of Incorporation,  the Corporation may
not incur any Indebtedness (unless the proceeds of such incurrence of
Indebtedness are used to make all overdue redemption payments in respect of the
Series C Preferred Stock, including  payments of accrued but unpaid  dividends
or  interest)  without the prior  written  consent of the  holders of the Series
C Preferred  Stock  voting separately as a class;  provided,  however, that,
subject to the restriction set forth in Section D.1(c)(i),  the Corporation may
incur Indebtedness  without the aforesaid  approval  if (A) the  proceeds  of
such  borrowing  are  used to pay obligations  of the  Corporation  arising in
the ordinary  course of business as they become due and payable,  or otherwise
to maintain  the  operations  of the Corporation  at the then  current  level
and not to expand the  operation of the Corporation in any material  respect,
whether through  expansion or enhancement of, or  addition,  to the
Corporation's  then current  activities,  facilities, equipment or other capital
assets,  or otherwise,  (B) the Corporation  provides prior  written  notice of
such  borrowing  to all  holders of Series C Preferred Stock,  which  notice
shall  include a  statement  of the  intended  use of the proceeds  of such
borrowing,  and  (C)  promptly  upon  request  therefor,  the Corporation  shall
provide  to  any  holder  of  Series  C  Preferred  Stock  a certificate  signed
by  the  President  and  Chief  Financial  Officer  of  the Corporation
certifying as to the allocation and use of the proceeds of any such borrowing.

                                                 (vii)      MULTIPLE  HOLDERS OF
SERIES C PREFERRED  STOCK.  If the Series C Preferred  Stock is at any time held
by more than one person or entity,  the request for redemption  pursuant to this
Section D.3 by the holders of at least fifty-one  percent (51%) of the then

<PAGE>

issued and outstanding  shares of Series C Preferred Stock shall  constitute the
request for redemption by the holders of all of the then issued and  outstanding
shares of Series C  Preferred  Stock and all such  holders of Series C Preferred
Stock shall  redeem their  shares of Series C Preferred  Stock  pursuant to this
Section  D.3 upon the  receipt  of notice  from  holders  of at least  fifty-one
percent  (51%) of the then issued and  outstanding  shares of Series C Preferred
Stock.

                                                 (viii)     APPRAISAL.  Within
fourteen (14) days of any written  request of any holder of shares of Series C
Preferred  Stock  from time to time,  the fair  market  value of the Series C
Preferred  Stock shall be determined by an appraiser or appraisers  according to
the terms and  procedures of Section  B.3(d)(viii),  except that all  references
shall be to Series C  Preferred  Stock and  Stockholders  rather  than  Series A
Preferred Stock and Stockholders.

                         4.         CONVERSION RIGHTS.

                                     (a)        OPTIONAL CONVERSION BY HOLDER.

                                           (i)         General  Provisions.
All, but not less than all, of the issued and outstanding shares of Series C
Preferred Stock shall be convertible, without the payment of any additional
consideration, into shares of Class C Common Stock,  at the option of the
holders of the shares of Series C Preferred  Stock, at any time. Each such share
of Series C Preferred Stock shall be convertible  at such time into one
fully-paid and  nonassessable share of Class C Common  Stock,  subject to
adjustment  as  provided in Section D.4.(e) below (the "Series C Conversion
Rate"). The holders of shares of Series C Preferred Stock requesting  conversion
of shares into shares of Class C Common Stock shall send a written notice to the
Corporation, at the principal office of the  Corporation,  requesting  such
conversion.  The  holders  shall,  as  soon thereafter as practicable,  deliver
the certificates therefor, duly endorsed for transfer,  at the principal  office
of the Corporation or any transfer agent for the Series C Preferred  Stock.  The
Corporation  shall,  as soon as practicable thereafter,  issue and deliver to
the holders a certificate or certificates  for the number of such shares of
Class C Common Stock to which the holders  shall be entitled,  a check  payable
to the  holders in the amount of any cash in lieu of issuance of any fractional
share, and the amount of any cumulative dividends and interest  accrued but
unpaid on such  shares  (unless,  and to the  extent,  the Corporation is
entitled to cancel  accrued  dividends as herein  provided).  The conversion
shall be deemed to have been made  immediately  prior to the close of business
on the date of receipt of the notice.  The persons  entitled to receive the
shares  of Class C Common  Stock  issuable  upon such  conversion  shall be
treated for all purposes as the record holder or holders of such shares of Class
C Common  Stock on such  date,  and the  shares  of  Series  C  Preferred  Stock
converted shall immediately be canceled and may not be reissued.


<PAGE>



                                                 (ii)       Multiple  Holders of
Series C Preferred  Stock.  If the Series C Preferred  Stock is at any time held
by more than one person or entity,  the request for conversion  pursuant to this
Section D.4 by the holders of at least fifty-one  percent (51%) of the then
issued and outstanding  shares of Series C Preferred Stock shall  constitute the
request for conversion by the holders of all of the then issued and  outstanding
shares of Series C  Preferred  Stock and all such  holders of Series C Preferred
Stock shall  convert their shares of Series C Preferred  Stock  pursuant to this
Section  D.4 upon the  receipt  of notice  from  holders  of at least  fifty-one
percent  (51%) of the then issued and  outstanding  shares of Series C Preferred
Stock.

                              (b)         AUTOMATIC  CONVERSION.  If the holders
of Series C Preferred  Stock have not earlier  exercised  their rights to
require the  Corporation to redeem their shares of Series C Preferred  Stock
pursuant to the provisions of Section  D.3.(a),  all of the  outstanding  shares
of Series C Preferred Stock shall,  together with all other then  outstanding
shares of the Corporation's preferred stock or other capital stock with rights
to convert into shares of Common Stock, be converted into fully-paid and
nonassessable shares of Class C Common Stock at the Series C  Conversion  Rate
upon the earlier to occur of the closing or other consummation of (i) any
Qualified Public Offering,  (ii) any  Non-Qualified  Public  Offering,  (iii)
any  combination,  consolidation or merger where the Corporation is not the
survivor,  or (iv) any sale, exchange or other  disposition  of all or
substantially  all of the  Corporation's  assets, whether  by asset or stock
sale or  otherwise.  Shares of Class C Common  Stock received  pursuant to this
Section  4.(b) shall be subject to the  provisions of Article  IV,  Section  A.4
in the  event  of a  Qualified  Public  Offering  or Non-Qualified Public
Offering,  and shall thereupon  immediately be reclassified as shares of Class A
Common  Stock.  At least  twenty  (20) days  prior  written notice of the date
fixed and place  designated for  conversion  shall be sent by first class mail,
postage  prepaid,  to the address of each holder of shares of Series C
Preferred  Stock as shown in the  records  of the  Corporation.  On or before
the date  fixed  for  conversion,  each  holder  of  shares  of Series C
Preferred Stock shall surrender the certificates representing such shares to the
Corporation at the place designated in such notice and shall thereafter  receive
certificates  for the number of full shares of Common Stock to which such holder
is entitled. Until such time as holders of certificates theretofore representing
shares of  Series C  Preferred  Stock  have  surrendered  them for  exchange  as
provided  herein,  no  dividends  shall  be  paid  with  respect  to any  shares
represented by such  certificates and no payment for fractional  shares shall be
made.

                                     (c)        NO  FRACTIONAL  SHARES.  No
fractional  shares of Common Stock shall be issued upon  conversion of shares of
Series C Preferred Stock. In lieu of any fractional share, the Corporation shall
pay a cash adjustment in respect of such  fractional  interest equal to the fair
market value of such fractional interest as determined by the Board.


<PAGE>


                                     (d)        PAYMENT OF  DIVIDENDS  AND
INTEREST.  At the time of the  conversion  of any  shares of Series C  Preferred
Stock,  and after payment in full by the  Corporation of all amounts of interest
and cumulative  dividends  accrued but unpaid with respect to Series A Preferred
Stock and Series B Preferred  Stock,  the  Corporation  shall, to the extent not
canceled  pursuant to Section 2(c), pay to the holder of such shares of Series C
Preferred  Stock the sum of all interest and  cumulative  dividends  accrued but
unpaid and then due with  respect to such Series C Preferred  Stock,  whether or
not such  dividends  shall have been declared by the  Corporation to the date of
conversion.

                                     (e)        ADJUSTMENTS;  ANTIDILUTION.  The
number of shares of Class C Common Stock  issuable upon the  conversion of the
Series C Preferred  Stock  shall be  subject  to  adjustment  from  time to time
upon the happening of certain events as follows:

                                                 (i)        DIVIDENDS,  SPLITS.
If the Corporation  declares a dividend payable in its shares of its Common
Stock,  splits any of its Common Stock or combines any of its outstanding shares
of Common  Stock  into a smaller  number,  then the  number  of  fully-paid  and
nonassessable  shares of Class C Common  Stock into which each share of Series C
Preferred  Stock may be converted shall forthwith be adjusted by multiplying one
(1) by a  fraction  (A) the  numerator  of which  shall be the  total  number of
outstanding shares of Common Stock immediately after such dividend,  stock split
or  combination,  and (B) the  denominator of which shall be the total number of
outstanding  shares of Common Stock  immediately  prior to such dividend,  stock
split or combination.

                                                 (ii)       REORGANIZATION,
RECLASSIFICATION.  In  the  event  of  a  reorganization,  share  exchange,  or
reclassification,  other than a change in par value, or from par value to no par
value,  or  from  no par  value  to par  value  or a  transaction  described  in
subsection  (iii) or (iv) below,  each share of Series C Preferred  Stock shall,
after such reorganization,  share exchange or  reclassification,  be convertible
into the kind and number of shares of stock or other  securities  or property of
the  Corporation to which the holder of Series C Preferred Stock would have been
entitled  if the  holder  had  held  the  Class C  Common  Stock  issuable  upon
conversion  of  its  Series  C  Preferred  Stock   immediately   prior  to  such
reorganization,  share exchange,  or reclassification,  or to which the Series C
Preferred Stock is actually entitled, but not both.

                                                 (iii)      CONSOLIDATION,
MERGER,  SALE OF  ASSETS.  In the  event of a merger or  consolidation  or sale,
exchange or other  disposition of all, or substantially all of the Corporation's
assets,  to which the  Corporation is a party,  each share of Series C Preferred
Stock shall,  after such merger or  consolidation,  be convertible into the kind
and number of shares of stock and/or other securities, cash or other property to
which the  holder of such  share of Series C  Preferred  Stock  would  have been
entitled  if the  holder  had  held  the  Class C  Common  Stock  issuable  upon
conversion of its shares of Series C Preferred Stock  immediately  prior to such
consolidation  or merger or sale of assets,  or to which the Series C  Preferred
Stock is actually entitled, but not both.


<PAGE>


                                                 (iv)       CERTAIN  ISSUANCES
OF ADDITIONAL  SHARES OF COMMON  STOCK.  If the  Corporation  shall issue any
additional  shares of Common Stock -- other than  securities to be issued (i) to
the public  pursuant to any Qualified  Public Offering or  Non-Qualified  Public
Offering,  (ii) to officers,  directors, or employees of the Corporation as part
of a stock option plan,  restricted  stock plan,  employee  stock purchase plan,
employment agreement, or other employee stock plan or agreement,  implemented by
the Board,  (iii) upon  conversion of any shares of the Series A Preferred Stock
or Series B Preferred Stock or the exercise of any warrant to purchase shares of
Common  Stock  held by the holder of any  Series A  Preferred  Stock or Series B
Preferred  Stock,  or(iv) to the LP  pursuant  to  Article  XIV of the  Practice
Participation  Agreement in respect of the issuance of Medical  Holdings Limited
Partnership  of the Limited  Partner  Interests  (or  options to  purchase  such
Interests)  from and after the time that more than  sixty-six (66) but less than
one hundred (100) physicians hold such Limited Partner  Interests (or options to
acquire  such  Interests)  directly or  indirectly  through  their  professional
corporations,  or (v) to any physician or physician group in  consideration  for
the  acquisition  of physician  practices  (or other  contracting  arrangements)
approved by the Board of  Directors -- for a  consideration  per share of Common
Stock less than the "conversion  price," as adjusted or as previously  adjusted,
in  effect  on the date  immediately  prior to such  issuance,  then and in such
event, such conversion price shall be adjusted, concurrently with such issuance,
to a price equal to the quotient obtained by DIVIDING:

                                                (1) an  amount  equal  to (x)
                        the sum of (A)  the  total  number  of  shares  of
                        Common  Stock  outstanding immediately prior to such
                        issuance or sale, plus (B) the total  number of shares
                        of Common  Stock  issuable  upon exercise  of all
                        options,  warrants  and  other  rights convertible or
                        exchangeable for, or evidencing the right to  purchase
                        shares  of,   Common  Stock   outstanding immediately
                        prior to such issuance or sale,  multiplied by (C) the
                        conversion price in effect  immediately prior to such
                        issuance or sale, plus (y) the consideration, if any,
                        received   or  deemed  to  be   received  by  the
                        Corporation upon such issuance or sale; BY

                                                (2) the sum of (A) the total
                        number of shares of Common Stock  outstanding
                        immediately  after such issuance or sale,  plus (B) the
                        total  number of shares of Common Stock  issuable upon
                        exercise of all options,  warrants and other rights
                        convertible  or  exchangeable  for, or evidencing the
                        right to purchase shares of, Common Stock outstanding
                        immediately after such issuance or sale.

For purposes of this Section D.4, the conversion  price per share shall be equal
to the  weighted  average  price  paid or to be paid by the  Series C  Preferred
Stockholder  for each  share of Series C  Preferred  Stock then  outstanding  or
subject to the  Option,  plus all  accrued  but unpaid  dividends  and  interest
thereon.


<PAGE>


No  adjustment  of the  conversion  price  shall  be  made  under  this  Section
D.4.(e)(iv) upon the issuance of any additional  shares of Common Stock that are
issued pursuant to the exercise of any warrants,  options or other  subscription
or purchase  rights or pursuant to the  exercise of any  conversion  or exchange
rights in any convertible  securities if any such  adjustments  shall previously
have been made upon the issuance of any such  warrants,  options or other rights
or upon the issuance of any convertible  securities (or upon the issuance of any
warrants, options or any rights therefor).

Notwithstanding  the foregoing  provisions of this Section  D.4.(e)(iv)  and the
provisions of Sections D.4.(e)(v) and D.4.(e)(vi),  the anti-dilution protection
afforded by this Section  D.4.(e)(iv)  shall apply to issuances of (A) shares of
the Company's capital stock, (B) warrants,  options or other rights to subscribe
for or  purchase  any  additional  shares of capital  stock,  or (C)  securities
convertible  into such stock,  made to (1)  founders,  officers,  directors  and
employees  of the Company in excess of the  equivalent  of  1,486,000  shares of
Common Stock at  purchase,  exercise or  conversion  prices less than 80% of the
fair market  value of a share of Common  Stock at the time of  issuance  and (2)
physicians in connection with  acquisition  transactions  and other  contracting
arrangements  at purchase,  exercise or  conversion  prices less than 80% of the
fair  market  value of a share of  Common  Stock  at the time of  issuance.  For
purposes of this  Section,  the fair market value of a share of the Common Stock
as of January __, 1997 shall be equal to $14.00.

                                         (v)    ISSUANCE OF WARRANTS,  OPTIONS
OR OTHER  RIGHTS.  If the  Corporation  at any time shall issue any warrants,
options or other rights to subscribe  for or purchase any  additional  shares of
Common Stock and the price per share for which additional shares of Common Stock
may at any time  thereafter be issuable  pursuant to such  warrants,  options or
other  rights  shall be less  than the  conversion  price  per  share in  effect
immediately prior to such issuance,  then such issue shall be deemed an issuance
(as of the date of issue of such warrants, options or other rights) of the total
maximum  number of shares of Common Stock  issuable  pursuant to such  warrants,
options or other rights, and the conversion price shall thereupon be adjusted as
provided  in  Section  D.4.(e)(iv)  hereof  on  the  basis  that  the  aggregate
consideration  for the additional  shares of Common Stock  issuable  pursuant to
such warrants,  options or other rights,  plus the minimum  consideration  to be
received by the  Corporation  for the  issuance of  additional  shares of Common
Stock pursuant to such warrants,  options, or other rights shall be deemed to be
the consideration received by the Corporation for the issuance of such warrants,
options, or other rights.

                                                 (vi)       CERTAIN  ISSUANCES
OF  CONVERTIBLE  SECURITIES.   In  case  the  Corporation  shall  issue  any
securities  convertible  into Common Stock and the  consideration  per share for
which  such  additional  shares of Common  Stock may at any time  thereafter  be
issuable pursuant to the terms of such convertible securities shall be less than
the  conversion  price per share in effect  immediately  prior to such issuance,

<PAGE>

then upon  such  issuance  of such  securities  the  conversion  price  shall be
adjusted  as provided  in Section  D.4.(e)(iv)  hereof on the basis that (i) the
maximum  number of  additional  shares of Common  Stock  necessary to effect the
conversion  or exchange of all such  convertible  securities  shall be deemed to
have been issued as of the date of issuance of such convertible securities,  and
(ii) the aggregate consideration for such maximum number of additional shares of
Common Stock plus the minimum consideration  received by the Corporation for the
issuance of such additional shares of Common Stock pursuant to the terms of such
convertible  securities shall be deemed to be the consideration  received by the
Corporation for the issuance of such  convertible  securities.  No adjustment of
the conversion  price shall be made under this  subsection  upon the issuance of
any  convertible  securities  which are issued  pursuant to the  exercise of any
warrants, options or other subscription or purchase rights therefor, if any such
adjustment  shall  previously have been made upon the issuance of such warrants,
options or other rights pursuant to Section D.4.(e)(v) hereof.

                                   (vii)      ADJUSTMENT OF SERIES C CONVERSION
RATE. Upon each adjustment of the conversion  price under the provisions of this
Section D.4.(e),  the conversion rate shall be adjusted to an amount  determined
by  dividing  the  conversion  price  then in effect by such adjusted conversion
price.

                                   (viii)     OTHER PROVISIONS APPLICABLE TO
ADJUSTMENTS UNDER THIS SECTION.  The following provisions will be applicable to
the making of adjustments in conversion prices hereinabove provided in this
Section D.4.(e):

                                                (1)         COMPUTATION OF
CONSIDERATION.  To the extent that any additional  shares of Common Stock or any
convertible securities or any warrants, options or other rights to subscribe for
or purchase any additional shares of Common Stock or any convertible  securities
shall be  issued  for cash  consideration,  the  consideration  received  by the
Corporation  therefor  shall be deemed to be the amount of the cash  received by
the  Corporation  therefor,  or, if such  additional  shares of Common  Stock or
convertible  securities are offered by the  Corporation  for  subscription,  the
subscription   price.   To  the  extent  that  such  issuance  shall  be  for  a
consideration  other than cash, then the amount of such  consideration  shall be
deemed to be the fair value of such  consideration  at the time of such issuance
as  determined  in good  faith by the  Corporation's  Board  after  receipt of a
fairness opinion, appraisal or similar independent third-party advice determined
by a person or entity jointly selected by the Series C Preferred Directors,  the
Series A Preferred  Directors,  the Series B Preferred  Directors  and the other
directors  pursuant to procedures  substantially  similar to those  contained in
Section 6 of the Stockholders  Agreement.  The  consideration for any additional
shares of Common  Stock  issuable  pursuant  to any  warrants,  options or other
rights to subscribe for or purchase the same shall be the consideration received
by the Corporation for issuing such warrants,  options or other rights, plus the
additional  consideration  payable to the Corporation  upon the exercise of such
warrants,  options or other rights.  The consideration for any additional shares
of Common Stock  issuable  pursuant to the terms of any  convertible  securities

<PAGE>

shall be the consideration  paid or payable to the Corporation in respect of the
subscription for or purchase of such convertible securities, plus the additional
consideration, if any, payable to the Corporation upon the exercise of the right
of  conversion  or  exchange  in  such  convertible  securities.  In case of the
issuance at any time of any  additional  shares of Common  Stock or  convertible
securities  in payment or  satisfaction  of any dividend upon any class of stock
preferred as to dividends in a fixed amount,  the Corporation shall be deemed to
have  received  for such  additional  shares  of  Common  Stock  or  convertible
securities  a  consideration  equal to the  amount of such  dividend  so paid or
satisfied.

                                                (2)         READJUSTMENT  OF
CONVERSION  PRICE.  Upon the expiration of the right to convert or exchange any
convertible  securities,  or upon  the  expiration  of any  rights,  options  or
warrants,  without  conversion,  exchange  or  exercise,  the  issuance of which
convertible  securities,  rights,  options or warrants effected an adjustment in
the conversion  price,  such conversion  price shall forthwith be readjusted and
thereafter  be the price  which it would  have been  (but  reflecting  any other
adjustments  in the  conversion  price made  pursuant to the  provisions of this
Section  D.4.(e)  after the  issuance of such  convertible  securities,  rights,
options or warrants) had the  adjustment of the  conversion  price made upon the
issuance or sale of such convertible  securities or issuance of rights,  options
or  warrants  been  made on the  basis of the  issuance  only of the  number  of
additional shares of Common Stock actually issued upon conversion or exchange of
such  convertible  securities,  or upon the exercise of such rights,  options or
warrants,  and thereupon  only the number of  additional  shares of Common Stock
actually  so issued,  if any,  shall be deemed to have been  issued and only the
consideration  actually  received by the  Corporation  (computed as set forth in
subsection D.4.(e)(viii)(1) hereof) shall be deemed to have been received by the
Corporation.  If the purchase price provided for in any such rights,  options or
warrants,  or the additional  consideration (if any) payable upon the conversion
or exchange of any convertible securities,  or the rate at which any convertible
securities  are  convertible  into or  exchangeable  for shares of Common  Stock
changes at any time  (other  than under or by reason of  provisions  designed to
protect  against  dilution),  the conversion  price in effect at the time of the
change shall be adjusted to the conversion  price that would have been in effect
at such time had such rights, options,  warrants or convertible securities still
outstanding provided for such changed purchase price,  additional  consideration
or conversion rate, as the case may be, at the time initially granted, issued or
sold.

                                                (3)         OTHER ACTION
AFFECTING  COMMON STOCK.  If the Corporation  shall take any action  affecting
the outstanding  number of shares of Common Stock, other than an action
described in any of the foregoing  subsections 4(e)(i) to (vii) hereof,
inclusive,  which in the opinion of the  Corporation's  Board would have a
materially  adverse effect upon the rights of the holders of the Series C
Preferred  Stock,  the conversion price  shall be  adjusted  in such  manner
and at such  time as the  Board  may determine to be equitable in the
circumstances.


<PAGE>


                                       (ix)     NOTICES OF ADJUSTMENTS.
Whenever the conversion rate and conversion  price is adjusted as herein
provided, an officer of the  Corporation  shall compute the adjusted  conversion
rate and conversion price in accordance with the foregoing provisions and shall
prepare a written  instrument  setting forth such adjusted  conversion rate and
conversion price and showing in detail the facts upon which such  adjustment is
based,  and such written instrument shall promptly be delivered to the record
holders of the Series C Preferred  Stock,  who shall approve such  conversion
rates and prices within 30 days of receipt.  If holders of Series C Preferred
Stock do not object in writing during such 30 day period, they shall be deemed
to have approved such conversion rates and prices for all purposes hereof.

                                   (f)  RESERVATION OF SHARES.  The Board shall
at all times reserve and keep available, out of its authorized but unissued
shares of Class C Common Stock, solely for the  purpose of effecting  the
conversion  of the shares of Series C Preferred Stock,  the full number of
shares of Class C Common Stock  deliverable  by the Corporation upon the
conversion of all shares of Series C Preferred  Stock from time to time
outstanding  and otherwise issuable under rights granted from the Corporation
then existing.

                                     (g)   NO IMPLIED MODIFICATION OF TERMS.
The provisions of this Section D.4. shall not give, or be deemed to give, the
Corporation the power or authority to issue any shares of its capital stock or
other  securities or to take any other action that it is expressly prohibited
from issuing by another provision hereof.

                         5.         LIQUIDATION RIGHTS.

                                     (a)        Upon any  liquidation,
dissolution or winding up of the affairs of the  Corporation,  whether
voluntary or involuntary,  the  holders of shares of the Series C  Preferred
Stock  shall be entitled  to  receive  out  of  the  assets  of the  Corporation
available  for distribution to  stockholders,  before any distribution or
payment shall be made in respect of the holders of shares of Common Stock or any
other class or series of  stock  ranking  junior  to the  Series  C  Preferred
Stock,  a  liquidating distribution in an amount equal to (a) the weighted
average (taking into account any shares received by Genesis Holdings,  Inc. upon
conversion of, or payment of interest under, that certain  Convertible
Subordinated Note (the "Note") of the Company  of even date  herewith)  price
paid or to be paid by the holder of the outstanding  Series C Preferred Stock
pursuant to the Stock Purchase  Agreement, Option  Agreement  and any
amendments  thereto,  or (b) in the  case of  shares received in payment of
interest under the Note,  $14.00 per share,  plus in each case all accrued but
unpaid dividends and interest thereon;

                                    provided,  however,  that the amount of cash
payable by the Corporation  shall not exceed the amount of cash paid to the
Corporation  by all holders of such shares with  respect to the purchase of such


<PAGE>

shares,  including the payment of any interest with respect thereto, through and
including  the date of  liquidation;  and  provided  further,  however,  that no
liquidating  distribution  shall be paid in respect of Series C Preferred  Stock
unless and until all  amounts  due to holders  of Series A  Preferred  Stock and
Series B Preferred Stockholders as a liquidating distribution and to holders and
guarantors  of  senior  indebtedness  of  the  Corporation  contemplated  in the
Operating  Plan shall have been fully  paid.  The  holders of shares of Series C
Preferred  Stock shall not be entitled  to receive any  additional  distributive
amounts upon such  liquidation,  dissolution or winding up of the affairs of the
Corporation resulting in any distribution of assets to stockholders.

                                     (b)        If, upon any such  liquidation,
dissolution or winding up of the affairs of the Corporation,  the assets of the
Corporation to  stockholders  shall be insufficient to permit the payment in
full to the holders of Series C Preferred Stock of the amounts to which they are
entitled,  then all of such available assets shall be distributed to the holders
of shares of Series C Preferred  Stock ratably in proportion to the  liquidation
payment  otherwise due under Section  D.5.(a) to each such holder and no amounts
shall be  distributed  in  respect of any other  share of  capital  stock of the
Corporation  other than  Series A Preferred  Stock and Series B Preferred  Stock
until all amounts distributable to holders of Series C Preferred Stock have been
distributed.

                                     (c)        The purchase or redemption by
the Corporation of stock of any class,  in any manner  permitted by law, shall
not  for  the  purpose  of this  Section  D.5.  be  regarded  as a  liquidation,
dissolution  or winding up of the  Corporation.  Neither the  consolidation  nor
merger of the Corporation  with or into any other  corporation or  corporations,
nor the sale or  transfer  by the  Corporation  of all or any part of its assets
shall  be  deemed  to  be a  liquidation,  dissolution  or  winding  up  of  the
Corporation for the purpose of this Section D.5.

                                     (d)        At least thirty (30) days prior
written  notice of any such  liquidation,  dissolution  or winding up of the
affairs of the Corporation stating a payment date, the amount of the liquidation
payments and the place where said liquidation  payments shall be payable,  shall
be sent by first  class  mail,  postage  prepaid,  to each  holder  of  Series C
Preferred Stock at his address as shown on the records of the Corporation.

                         6.         EVENTS OF NON-COMPLIANCE; NON-COMPLIANCE.

                                     (a)        DEFINITION.  "Event of
Non-Compliance"  shall mean, with respect to the Corporation,  the occurrence of
any of the events,  occurrences or circumstances  listed below;  provided,
however, that   any   such   event,   occurrence   or   circumstance   shall
constitute "Non-Compliance"  if, and only if, (i) in the case of any event,
occurrence  or circumstance  involving  the  non-payment  of moneys  (other than

<PAGE>


dividend  and accrued  interest  payments due and payable to the holders of
Series C Preferred Stock),  within  thirty (30)  calendar  days  following
written  notice of such non-payment,  such moneys have not been paid by or on
behalf of the Corporation; and (ii) in the case of any event,  occurrence or
circumstance not involving the non-payment  of moneys,  substantial  efforts
have not been  commenced by or on behalf of the Corporation to cure such event,
occurrence, or circumstance within a reasonable time after notice thereof (but
in no event later than 30 days), and having  been so  commenced,  there  is a
failure  within a  reasonable  time to prosecute to completion  with diligence
and continuity the curing of such event, occurrence  or  circumstances,  or a
period  of more  than 90 days has  occurred without  such cure being  completed
to the  satisfaction  of the holders of the Series C Preferred Stockholders;
provided, further, however, that, for purposes of (i) and (ii)  above  the
occurrence  of any of the  events,  occurrences  or circumstances  described in
subparagraphs (4) through (9) below shall constitute Non-Compliance  immediately
upon its  occurrence  or upon the happening of such event or  circumstances,
without any  requirement  of notice or passage of time except as specifically
set forth in such item:

                                                (1)         any failure of the
Corporation to make any payment  required to be made by it to the holders of
Series C Preferred Stock hereunder when due;

                                                (2)        any  material
default  by the  Corporation  in the  payment  of any other  material
obligation  of the Corporation to any holder of Series C Preferred  Stock;
including  specifically but without limitation payment obligations  pursuant to
any contract,  agreement or other  business  transaction  entered  into between
the  Corporation  and any holder of Series C Preferred Stock in the ordinary
course of the Business of the Corporation.

                                                (3)         the  Corporation
otherwise  breaches or  otherwise  fails to perform or observe in any material
respect  any  material  covenant  or  agreement  set  forth  herein  or  in  the
Registration  Rights  Agreement  dated  as of  September  4,  1996  between  the
Corporation  and the  initial  holders  of the Series C  Preferred  Stock or the
Stockholders Agreement;

                                                (4)         institution  by the
Corporation  of  proceedings  of any nature under any laws or  regulations,
whether now existing or subsequently enacted or amended, for the relief of
debtors wherein the Corporation is seeking relief as debtor;

                                                (5)         a general assignment
by the Corporation for the benefit of creditors;

                                                (6)         the  institution by
the Corporation of a case or other  proceeding  under any section or chapter of
the Federal Bankruptcy Code as now existing or hereafter amended or becoming
effective;


<PAGE>

                                                (7)         the  institution
against the  Corporation  of a case or other  proceeding  under any section or
chapter of the Federal  Bankruptcy Code as now existing or hereafter  amended or
becoming  effective,  which  proceeding is not  dismissed,  stayed or discharged
within a period of ninety (90) calendar days after the filing thereto;

                                                (8)         the  appointment of
a receiving,  custodian,  trustee or like officer to take  possession of the
assets of the Corporation, if the tendency of said receivership would reasonably
tend to have a materially adverse effect upon the performance by the Corporation
of its obligations hereunder, which receivership imposition;

                                                (9)        admission by the
Corporation in writing of its inability to pay its debts as they mature or the
Corporation is adjudicated as insolvent;

                                                (10)        attachment,
execution  or  other  judicial  seizure  of  all  or any  substantial  part  of
the Corporation's  assets,  such  attachment,  execution  or  seizure  in  any
case remaining undismissed or undischarged for a period of fifteen (15) calendar
days after the levy thereof;  provided,  however, that said attachment,
execution or seizure  shall  not  constitute  an Event  of  Non-Compliance
hereunder  if the Corporation  posts a bond  sufficient in amount to satisfy or
secure the payment of such claim or judgment within sixty (60) calendar days
after the levy thereof and  the  Corporation's  assets  are  thereby  released
from  the  lien of such attachment;

                                                (11)        one or more
judgments or decrees is entered against the  Corporation or any of its
Subsidiaries involving  in the  aggregate a  liability  (to the extent not paid
or covered by current insurance) of the greater of $1,000,000, or (B) ten
percent (10%) of the net operating  earnings of the Corporation for the
immediately  preceding fiscal year, as calculated by the independent  certified
public accountants employed by the  Corporation,  and all such  judgments  or
decrees  have not been  vacated, discharged,  stayed  or  bonded  pending
appeal  within  60 days from the entry thereof; or

                                                (12) any  holder of
Indebtedness  of the  Corporation  equal to the  greater  of  $1,000,000  or (B)
or ten percent  (10%)  of the  net  operating  earnings  of  the  Corporation
for  the immediately  preceding  fiscal year, as calculated by the independent
certified public  accountants  employed  by the  Corporation,  after a default
under such Indebtedness shall commence proceedings, or take any action
(including by way of set-off) to retain in  satisfaction of such  Indebtedness
or to collect,  seize, dispose  of,  or apply  in  satisfaction  of such
Indebtedness,  assets  of the Corporation  having  a  fair  market  value  in
excess  of the  greater  of (A) $1,000,000  or (B) ten  percent  (10%)  of the
net  operating  earnings  of the Corporation  for the  immediately  preceding
fiscal year,  as calculated by the independent   certified   public
accountants   employed  by  the  Corporation, individually or in the aggregate
(including funds on deposit or held pursuant to lock-box and other similar
arrangements).


<PAGE>

            E.          PREFERRED STOCK.  Subject to such rights and
restrictions as may be granted to, and benefit,  the Class A Common Stock, the
Class B Common Stock,  the Class C Common Stock,  the Series A Preferred  Stock,
the Series B Preferred Stock and the Series C Preferred Stock, the Board shall
have the power to classify or reclassify  all remaining  shares of Preferred
Stock  pursuant to the powers granted by the provisions of Article V, Section 2
and Section 3 hereof.

                                   ARTICLE V
                               BOARD OF DIRECTORS

                                      1.          NUMBER.  The  Corporation
shall  have nineteen  (19)  directors.  Five (5) of such directors  shall be
Class A Common Directors,  eight (8) shall be Class B Common Directors, two (2)
shall be Series A Preferred Directors, two (2) shall be Series B Preferred
Directors and two (2) shall be Series C Preferred  Directors.  These numbers may
not be increased or decreased except as provided  herein.  The Corporation shall
have (a) two (2) Converted  Series A Class C Common Directors only upon
conversion of all shares of Series A  Preferred  Stock into shares of Class C
Common  Stock as otherwise provided herein,  (b) two (2) Converted  Series B
Class C Common Directors only upon conversion of all shares of Series B
Preferred Stock into shares of Class C Common Stock as otherwise  provided
herein and (c) two (2) Converted  Series C Class C Common  Directors  only  upon
conversion of all shares  of  Series C Preferred Stock  into  shares  of Class C
Common Stock as otherwise  provided herein.  Upon conversion  of all shares of
Series A Preferred  Stock,  Series B Preferred Stock and Series C Preferred
Stock into shares of Class C Common Stock as otherwise  provided herein,  the
Series A Preferred  Directors, the Series B Preferred  Directors  and the Series
C Preferred  Director or Directors who are duly elected and qualify as of the
time of such conversion  shall be and become, respectively,  the Converted
Series A Class C Common  Directors,  the Converted Series  B Class C Common
Directors and the Converted  Series C Class C Common Directors,  who shall serve
until their successors are duly chosen and qualify. Except as otherwise provided
herein, the number of directors,  and the number of directors  that may be
elected  by the holders  of each of the  Class A Common Stock,  the Class B
Common Stock,  the Converted  Series A Class C Common Stock, the  Converted
Series B Class C Common Stock,  the  Converted  Series C Class C Common Stock,
the Series A Preferred Stock, the Series B Preferred Stock and the Series C
Preferred  Stock may be changed  only by an  amendment  to the charter approved
by the vote of stockholders  entitled to vote at least two-thirds (2/3) of the
shares of each of the Class A Common Stock, the Class B Common Stock, the
Converted  Series A Class C Common Stock,  the Converted Series B Class C Common
Stock,  the  Converted Series C Class C Common  Stock,  the Series A  Preferred
Stock, the Series B Preferred Stock or the Series C Preferred Stock, as the case
may be.

<PAGE>


                                     2.         BOARD  AUTHORIZATION  OF STOCK
ISSUANCE.  Subject to such rights and  restrictions as may be granted to, and
benefit,  the Class A Common Stock,  Class B Common Stock, Class C Common Stock,
the Series A  Preferred  Stock,  the Series B  Preferred  Stock and the Series C
Preferred  Stock  hereunder,  the Board is hereby  empowered  to  authorize  the
issuance  from  time to time of  shares  of its  stock of any  class or  series,
whether now or hereafter authorized,  and securities  convertible into shares of
its stock,  of any class of classes,  whether now or hereafter  authorized,  for
such consideration as the Board may deem advisable.

                                     3.         CLASSIFICATION  OF STOCK.
Subject to such rights and  restrictions  as may be granted to, and benefit,
the Class A Common Stock,  the Class B Common Stock,  the Class C Common Stock,
the Series  A  Preferred  Stock,  the  Series B  Preferred  Stock  and the
Series C Preferred  Stock  hereunder,  until such time,  if any,  as all Common
Stock is automatically  converted to Class A Common Stock pursuant to Article
IV, Section A.4  hereto,  the Board  shall  have the power to  classify  or
reclassify  any unissued stock  (including but not limited to authorized but
unissued  shares of Preferred Stock),  whether now or hereafter  authorized,  by
setting or changing the  preferences,  conversion  or other  rights,  voting
powers,  restrictions, limitations as to dividends, qualifications or terms or
conditions of redemption of such stock. Upon any such classification or
reclassification, the Board shall cause the  Corporation  to file articles
supplementary  with the Maryland State Department of Assessments and Taxation,
containing such provisions,  if any, as may at such time be required by the
MGCL.

                                     4.         CONFLICT OF INTEREST.  No
contract or other transaction  between the Corporation and any other
corporation, partnership,  individual or other entity and no act of the
Corporation  shall in any way be affected or  invalidated by the fact that any
of the directors of the Corporation  are  directors,  principals,  partners  or
officers  of such other entity, or are pecuniarily or otherwise interested in
such contract, transaction or act;  provided that (i) the existence of such
relationship  or such interest shall be  disclosed  to the Board or to a
committee  of the Board if the matter involves a committee  decision,  and the
contract,  transaction  or act shall be authorized, approved or ratified by a
majority of disinterested directors on the Board  or on  such  committee,  as
the  case  may  be,  even  if the  number  of disinterested  directors
constitutes less than a quorum,  or (ii) the contract, transaction or act shall
be authorized, ratified or approved in any other manner provided by the MGCL.


<PAGE>


                                   ARTICLE VI
            PROVISIONS CONCERNING CERTAIN RIGHTS OF THE CORPORATION
                              AND THE SHAREHOLDERS

                        1.          RIGHT TO AMEND  CHARTER.  Subject to (a) the
rights  granted to the holders of Series A Preferred  Stock as exercised by the
Series A Preferred Directors pursuant to Article IV, Section B.1(c), and (b) the
rights  granted to the holders of Series B Preferred  Stock as  exercised by the
Series B Preferred  Directors pursuant to Article 4, Section C.1(c), and (c) the
rights  granted to the holders of Series C Preferred  Stock as  exercised by the
Series C Preferred  Directors  pursuant to Article 4,  Section  D.1(c),  the
Corporation reserves the right to make, from time to time, any amendments of its
charter  which  may  now or  hereafter  be  authorized  by  law,  including  any
amendments which alter the contract rights of any holder of class of outstanding
stock as expressly set forth in the charter.

                        2.          ADDITIONAL  ISSUANCES;  PREEMPTIVE  RIGHTS.
No holder of stock of any class shall be entitled to  preemptive  rights to
subscribe for or purchase or receive any part of any new or additional  issue of
stock of any class of the Corporation or securities  convertible  into stock of
any class of the Corporation.

                        3.          INAPPLICABILITY  OF THE MARYLAND  CONTROL
SHARE AND BUSINESS  COMBINATION  STATUTES.  The  Corporation  elects not to be
governed  by  Subtitle 6 of Title 3 of the MGCL with  respect  to any  "business
combination"  as defined in such Subtitle,  and any acquisition of any shares of
stock of the  Corporation,  including any  acquisition of voting rights or other
interests  in any such stock,  shall be exempt from the  provisions  of Title 3,
Subtitle  7 of the MGCL.  Accordingly,  the  provisions  of Title 3,  Subtitle 6
(Business  Combination)  and  Subtitle 7  (Control  Share) of the MGCL shall not
apply to this Corporation.

                        4.         CONSENT.  Where the consent or  approval of
any  stockholder  or  director  of the  Corporation  is required hereunder,
such  consent  or  approval  may  be  given  or  withheld  in  such
stockholder's or director's sole discretion.


                                  ARTICLE VII
                  INDEMNIFICATION AND LIMITATION OF LIABILITY

                        1.         MANDATORY  INDEMNIFICATION.  To the maximum
extent permitted by the MGCL, as from time to time amended,  the Corporation
shall indemnify its currently  acting and its former  directors and officers
against any and all  liabilities  and expenses  incurred in connection with
their services in such capacities.

                        2.          DISCRETIONARY  INDEMNIFICATION.  If approved
by the Board, the Corporation may indemnify its officers, employees, agents and
persons who serve and have  served,  at its request as a director,  officer,

<PAGE>

partner, trustee, employee or agent of another corporation, partnership,  joint
venture or other enterprise as may be determined by the Board.

                        3.          ADVANCING  EXPENSES PRIOR TO A DECISION. The
Corporation  shall advance expenses to its directors and officers entitled to
mandatory indemnification to the maximum extent permitted by the MGCL and may in
the discretion of the Board advance expenses to officers,  employees,  agents
and others who may be granted indemnification.

                        4.          OTHER  PROVISIONS  FOR  INDEMNIFICATION. The
Board  may,  by  resolution  or agreement,  make  further  provision  for
indemnification of directors, officers, employees and agents of the Corporation.

                        5.          LIMITATION  OF  LIABILITY  OF  DIRECTORS AND
OFFICERS.  To the maximum  extent that limitations  on the  liability of
directors  and officers are permitted by the MGCL, as from time to time amended,
no director  or officer of the  Corporation shall  have any  liability  to the
Corporation or its stockholders for money damages.  This limitation on liability
applies to events occurring at the time a person serves as a director or officer
of the  Corporation  whether or not such person is a director or officer at the
time of any proceeding in which liability is asserted.

                        6.          EFFECT OF  AMENDMENT  OR REPEAL.  No
amendment  or repeal of this  Section,  or the  adoption of any  provision  of
the Corporation's  charter inconsistent with this Section,  shall apply to or
affect in any respect the liability of any director or officer of the
Corporation  with respect to any alleged act or omission which  occurred prior
to such  amendment, repeal or adoption.

            SECOND:  The Board of  Directors  of the  Corporation,  by unanimous
resolution  filed with the  minutes  of  proceedings  of the Board by  unanimous
consent  in lieu of  meeting  dated  January  27,  1997,  adopted  a  resolution
declaring  that  the  amendments  set  forth  in  the  foregoing  amendment  and
restatement  of  the  charter  were   advisable,   approved  the  amendment  and
restatement  of the  charter  hereinabove  set forth,  and  directed  that it be
submitted for action thereon by the stockholders.

            THIRD: The stockholders of the Corporation, at a duly called meeting
held  on  January  30,  1997,  the  stockholders   approved  the  amendment  and
restatement of the charter of the Corporation hereinabove set forth.

            FOURTH:  (a) The total number of shares of all classes of stock of
the Corporation  HERETOFORE  authorized,  and the number and par value of the
shares of each class were as follows:

<PAGE>

                                                         Sixty-Three  Million
                                    One  Hundred  Seventy-Six  Thousand  Nine
                                    Hundred  Eighty-Four (63,176,984)   shares
                                    of   capital   stock, consisting  of Twenty
                                    Million Seven Hundred Thousand  (20,700,000)
                                    shares  of  Class  A Common Stock, having a
                                    par value of One Cent ($0.01) per share, Ten
                                    Million  (10,000,000) shares of Class B
                                    Common Stock, having a par value  of  One
                                    Cent   ($0.01)   per  share, Twenty-Nine
                                    Million    Fifty    Thousand (29,050,000)
                                    shares of Class C Common Stock, having a par
                                    value of One Cent  ($0.01)  per share,  One
                                    Million  (1,000,000)  shares of Series A
                                    Convertible Preferred Stock, having a par
                                    value  of Five  Dollars  ($5.00)  per share,
                                    Three  Hundred  Fifty-Five  Thousand Five
                                    Hundred  Fifty-Six  (355,556) shares of
                                    Series B Convertible Preferred Stock, having
                                    a  par   value   of   Eleven   Dollars   and
                                    Twenty-Five  Cents  ($11.25) per share,  One
                                    Million  Seventy-One  Thousand  Four Hundred
                                    and  Twenty  Eight  (1,071,428)   shares  of
                                    Series C Preferred Stock, having a par value
                                    of   Seventeen   Dollars   and  Fifty  Cents
                                    ($17.50)   per   share;   and  One   Million
                                    (1,000,000)   shares  of  Preferred   Stock,
                                    having a par value of One Cent  ($0.01)  per
                                    share.

                        (b)         The total number of shares of all classes of
stock of the Corporation as increased,  and the number and par value of the
shares of each class, are as follows:

                                                                Sixty-Three
                                    Million Six  Hundred  and Five  Thousand
                                    Five  Hundred  and  Fifty-Six (63,605,556)
                                    shares  of   capital   stock, consisting  of
                                    Twenty  Million Seven Hundred Thousand
                                    (20,700,000)  shares  of  Class  A Common
                                    Stock,  having par value of One Cent ($0.01)
                                    per share, Ten Million  (10,000,000) shares
                                    of Class B Common Stock, having a par value
                                    of  One  Cent   ($0.01)   per  share,
                                    Twenty-Nine     Million    Fifty    Thousand
                                    (29,050,000) shares of Class C Common Stock,
                                    having a par value of One Cent  ($0.01)  per
                                    share,  One  Million  (1,000,000)  shares of
                                    Series A Convertible Preferred Stock, having
                                    a par  value  of Five  Dollars  ($5.00)  per
                                    share,  Three  Hundred  Fifty-Five  Thousand
                                    Five Hundred  Fifty-Six  (355,556) shares of
                                    Series B Convertible Preferred Stock, having
                                    a  par   value   of   Eleven   Dollars   and
                                    Twenty-Five  Cents  ($11.25) per share,  One
                                    Million,  Five Hundred Thousand  (1,500,000)
                                    shares  of  Series C  Convertible  Preferred
                                    Stock,   having  a  par  value  of  Fourteen
                                    Dollars  ($14.00) per share, and One Million
                                    (1,000,000)   shares  of  Preferred   Stock,
                                    having a par value of One Cent  ($0.01)  per
                                    share.


                                    The aggregate par value of all shares of all
classes of stock of the Corporation  heretofore authorized was Twenty-Eight
Million Three Hundred  Fifty-Seven  Thousand  Four Hundred  Ninety-Five  Dollars
($28,357,495).  The  aggregate  par value of all shares of all  classes of stock
having a par value, as amended by this Amendment,  is Thirty Million Six Hundred
Seven  Thousand  Five Hundred and Five  Dollars  ($30,607,505).  This  amendment
increases  the  aggregate par value of all shares of all classes of stock of the
Corporation.

<PAGE>

            FIFTH: A description,  as amended,  of each class of stock which the
Corporation is authorized to issue,  including the  preferences,  conversion and
other  rights,  voting  powers,  restrictions,   limitations  as  to  dividends,
qualifications  and terms and conditions of redemption,  is set forth in Article
FIRST above.

            SIXTH: The names of the directors of the Corporation  currently in
office are: (a) Class A Common  Directors:  Scott Rifkin,  M.D., Alan Kimmel,
M.D., Paul Serini,  John Dwyer and Stewart Gold; (b) Class B Common  Directors:
J. David Nagel,  M.D., Howard Goldman,  M.D., Peter LoPresti,  M.D., Robert
Graw, M.D., Mark Eig, M.D., Alexander Rocha, M.D., William Lamm, M.D. and Robert
Ancona, M.D.; (c) Series A Preferred Directors:  John Prout and John Ellis; (d)
Series B Preferred Director: Robert Zetzer; and (e) Series C Preferred Director:
Richard Howard.

            IN WITNESS  WHEREOF,  the  Corporation  has caused these Articles of
Amendment  and  Restatement  to be executed in its name and on its behalf by its
President and attested by its Secretary on the ____ day of January, 1997.

            The  undersigned   acknowledges  these  Articles  of  Amendment  and
Restatement to be the act of the  Corporation,  and states,  under penalties for
perjury,   that  the  matters  and  facts  set  forth  herein  with  respect  to
authorization  and approval  thereof are true in all material  respects,  to the
best of his knowledge, information and belief.


ATTEST:                                     DOCTORS HEALTH SYSTEM, INC.


                                            By:
- -------------------------                        ----------------------------
Paul A. Serini, Secretary                          Stewart B. Gold, President






                                                                    EXHIBIT 10.5



                                February 1, 1997



Doctors Health System, Inc.
10451 Mill Run Circle, 10th Floor
Owings Mills, Maryland  21117
Attention:  Stewart B. Gold, President

Dear Stewart:

                  My  understanding  is that Section 4(f)(ii) of the Amended and
Restated  Stockholders  Agreement among Doctors Health System,  Inc. ("DHS") and
the  stockholders of DHS (the  "Stockholders  Agreement")  provides that, in the
event of my  disability,  I may  require DHS to purchase my shares of DHS Common
Stock in the event that the other  stockholders  decline to purchase such stock.
In  addition,  it is my  understanding  that  DHS may  terminate  my  Employment
Agreement  with DHS dated  December 9, 1994,  as amended  from time to time (the
"Employment  Agreement") in the event of a disability pursuant to Section 4.2 of
the Employment Agreement.  By signing this letter, I agree to execute amendments
to the  Stockholders  Agreement and Employment  Agreement in accordance with the
terms of this letter.

                  This letter will  confirm my agreement  that,  effective as of
February 1, 1997, in the event I become disabled (and not for any other reason),
I waive my right to require DHS to purchase any of my shares of DHS Common Stock
of whatever class,  including shares issuable upon the exercise of stock options
(i) to the extent such  purchase  price would  exceed the amount  payable to DHS
pursuant  to any  disability  insurance  policy  maintained  by DHS to fund such
purchase  right and/or (ii) to the extent any  disability is not covered by such
disability  insurance  policy.  You  have  agreed  that  the  DHS  will  use its
commercially  reasonable  efforts to obtain  the  maximum  amount of  disability
insurance  coverage  to  fund  the  stock  repurchase  right  described  in  the
Stockholders Agreement.



<PAGE>


Doctors Health System, Inc.
February 1, 1997
Page 2



                  I have agreed to waive these rights in consideration  that DHS
shall amend the Employment  Agreement to provide that if my employment  with DHS
is  terminated  due to a  disabililty  which is not  covered  by the  applicable
disability insurance policy, DHS shall in such event provide me with a severance
benefit equal to my salary pursuant to the Employment  Agreement,  from the date
of termination of employment  due to disability  until the first  anniversary of
expiration of the term of the Employement Agreement.

                  I  understand  that the  arrangements  described  above  shall
terminate  upon  the  occurrence  of a  Change  in  Control  as  defined  in the
Stockholders Agreement.

                                                     Very truly yours,



                                                     Scott Rifkin

Agreed and Accepted as of
this 1st day of February, 1997

DOCTORS HEALTH SYSTEM, INC.



By: ________________________
    Stewart B. Gold, President





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