LEASE AGREEMENT 

                       HRT OF ROANOKE, INC. 
                     a Virginia corporation  

                          (Landlord) 
                             AND

                  LEWIS-GALE  CLINIC,   L.L.C.  
            a  Virginia  limited  liability  company  
                            (Tenant)

                            Property:
                      Lewis-Gale Clinic 
                     1802 Braeburn Drive 
                         Salem, Virginia 

                       

                 November      14,     1996   

                   TABLE     OF      CONTENTS 
   
SEC. 1.  DEFINITIONS...................................................1
SEC. 2.  BASE RENT AND CPI INCREASE....................................2
SEC. 3.  ADDITIONAL RENT...............................................2
SEC. 4.  RENT PAYMENT..................................................4
SEC. 5.  PAYMENT FOR OTHER SERVICES....................................4
SEC. 6.  TENANT'S OCCUPANCY AND USE....................................4
SEC. 7.  LANDLORD'S RIGHT OF ACCESS....................................4
SEC. 8.  QUIET POSSESSION..............................................4
SEC. 9.  SERVICES AND UTILITIES........................................5
SEC. 10. REPAIRS AND MAINTENANCE.......................................5
SEC. 11. TENANT'S ALTERATIONS, FIXTURES AND PERSONAL PROPERTY..........5 
SEC. 12. CONDITION OF THE PREMISES.....................................6
SEC. 13. LIENS BY TENANT...............................................6
SEC. 14. SUBLETTING AND ASSIGNING......................................6
SEC. 15. FIRE AND CASUALTY.............................................7
SEC. 16. WAIVER OF SUBROGATION.........................................7
                                       


SEC. 17. DEFAULT BY TENANT.............................................7
SEC. 18. DEFAULT BY LANDLORD...........................................7
SEC. 19. INSURANCE.....................................................8
SEC. 20. ATTORNEY'S FEES...............................................9
SEC. 21. CONDEMNATION..................................................9
SEC. 22. PAYMENT OF IMPOSITIONS.......................................10
SEC. 23. TAXES ON TENANT'S PROPERTY...................................10
SEC. 24. SIGNS........................................................10
SEC. 25. RULES AND REGULATIONS........................................10
SEC. 26. HOLDING OVER.................................................10
SEC. 27. NON-WAIVER...................................................10
SEC. 28. SUBORDINATION AND ATTORNMENT ................................10
SEC. 29. TRANSFER OF LICENSES.........................................11
SEC. 30. SUCCESSORS AND ASSIGNS.......................................11
SEC. 31. TIME.........................................................11
SEC. 32. APPLICABLE LAW...............................................11
SEC. 33. SEVERABILITY.................................................11
SEC. 34. AUTHORITY OF TENANT..........................................11

                                      


SEC. 35. BROKERS......................................................11
SEC. 36. NOTICES......................................................12
SEC. 37. RELATIONSHIP OF LEASE TO LEASE ADMINISTRATION AGREEMENT......12   
SEC. 38. ENTIRE AGREEMENT.............................................12
SEC. 39. COUNTERPARTS.................................................13
EXHIBIT A\............................................................14


                                LEASE AGREEMENT
                            Medical Office Facility

     This Lease  Agreement  (the Lease) made and entered into as of the 14th day
of November,  1996,  between HRT OF ROANOKE,  INC., a Virginia  corporation (the
Landlord),  and LEWIS-GALE CLINIC,  L.L.C., a Virginia limited liability company
(the Tenant).

                            W I T N E S S E T H : 
     In consideration of the rents, mutual covenants and agreements set forth
herein,  the Landlord  hereby  leases to Tenant,  and Tenant  hereby leases from
Landlord those certain  premises  located in Salem,  Virginia and being known as
the Lewis-Gale  Clinic  (herein  called the Building),  located at 1802 Braeburn
Drive which  premises  consist of  approximately  225,227  rentable  square feet
(herein  called the Premises) and being all of the  improvements  located on the
real  property  more  particularly  described  in Exhibit A attached  hereto and
incorporated  herein.  The total rentable area of the Building is 237,244 square
feet and the Premises  (Tenant's pro rata share for Additional Rent purposes) is
agreed to be 95% thereof.  The rentable square footage area shall be used in the
calculation  of rent and other sums as  appropriate  under this  Lease.  

     SEC. 1. DEFINITIONS: For purposes of this Lease, the following terms
shall have the meanings  hereinafter ascribed thereto: 

     a. ANNUAL BASE RENT (BASE RENT):  Initial Lease Year:  $164,865.00 per year
($15.00/Rentable  SF) for the 10,991 rentable square feet located in the Phase I
basement;  $3,856,248.00 per year ($18.00/Rentable SF) for the remaining 214,236
rentable square feet for a total annual rental of $4,021,113.00 payable monthly.
Base Rent for each Lease Year after  Initial  Lease Year (the Initial Lease Year
begins on  November 1, 1996 and ends on October 31,  1997) to be  determined  in
accordance with Section 2(b).

     b. COMMERCIALLY  REASONABLE:  The term  Commercially  Reasonable shall mean
that which is the fair market cost for comparable goods and services provided in
a first class  manner in the area of the Property  (as defined  hereinafter)  as
evidenced by objective third party criteria,  including without  limitation that
certain Market Value  Appraisal  Update,  dated as of July 1, 1995,  prepared by
Linwood M. Aron,  MAI,  SREA,  and provided to Landlord by  Lewis-Gale  Building
Corporation in connection with the Property, as adjusted by increases in the CPI
(as defined hereinafter). 

     c. IMPOSITIONS: Collectively, all taxes (including, without limitation, all
capital stock and franchise  taxes of Landlord,  all ad valorem,  sales and use,
single business, gross receipts,  transaction privilege, rent or similar taxes),
assessments   (including,   without  limitation,   all  assessments  for  public
improvements  or benefits,  whether or not  commenced or completed  prior to the
date hereof and whether or not to be completed  within the Lease  Term),  ground
rents,  water,  sewer or other rents and  charges,  excises,  tax  levies,  fees
(including, without limitation,  license, permit, inspection,  authorization and
similar fees),  and all  governmental  charges,  in each case whether general or
special,  ordinary  or  extraordinary,  or  foreseen  or  unforeseen,  of  every
character in respect of the Property  (as defined  hereinafter)  and/or the rent
(including  all interest and penalties  thereon due to any failure in payment by
Tenant),  which at any time prior to, during or in respect of the Lease Term may
be  assessed  or imposed on or in respect of or be a lien upon (a)  Landlord  or
Landlord's interest in the Property, (b) the Property or any part thereof or any
rent  therefrom  or any estate,  right,  title or interest  therein,  or (c) any
occupancy,  operation,  use or possession of, sales from, or activity  conducted
on, or in connection with, the Property or the leasing or use of the Property or
any part thereof;  provided,  however, nothing contained in this Agreement shall
be construed to require Tenant to pay (1) any interest and penalties relating to
failure of the Landlord to timely pay any such Imposition;  provided that Tenant
shall  have  timely  paid its rents,  (2) any tax based on net  income  (whether
denominated as a franchise or capital  stock,  financial  institutions  or other
tax) imposed on Landlord,  (3) any transfer or net revenue tax of Landlord,  (4)
any tax imposed with respect to  inheritance,  estate,  succession,  transfer or
gift taxes or the sale, exchange or other disposition by Landlord of any portion
of the Property or the  proceeds  thereof,  or (5) except as expressly  provided
elsewhere in this Lease,  any  principal or interest on any  encumbrance  on the
Property,  except to the  extent  that any tax,  assessment,  tax levy or charge
which  Tenant  is  obligated  to pay  pursuant  to the  first  sentence  of this
definition  and which is in effect at any time  during the Lease Term is totally
or partially repealed,  and a tax,  assessment,  tax levy or charge set forth in
clause (2) or (3) is levied,  assessed or imposed expressly in lieu thereof,  in
which case Tenant shall pay.

                                       1


     d.  LEASE  ADMINISTRATION  AGREEMENT:  That  certain  Lease  Administration
Agreement,  executed of even date herewith,  by and between Landlord and Tenant,
pursuant  to which  Landlord  (i)  granted to Tenant  certain  rights to use and
control  certain  aspects  of the  Building  and (ii)  Tenant  agreed to pay the
Property Rents (as defined in the Lease Administration  Agreement) and to ensure
the  performance of the obligations of the tenants under the Property Leases (as
defined in the Lease Administration Agreement). 
     
     e. LEASE TERM: 15 years from the Lease Term  Commencement  Date,  with five
(5) five-year  renewal options to be exercised in accordance with the provisions
of  Section  13.5  of  the  Lease  Administration   Agreement.   

     f.  LEASE  TERM COMMENCEMENT  DATE:  November  14,  1996.  
     
     g. LEASE YEAR:  The twelve (12) month period from November 1 to October 31.

     h. PERMITTED USE OF PREMISES:  Use only as a medical facility or for 
general commercial  purposes ancillary to the care and treatment of human beings
 or the practice of medicine. 

     i. TENANT'S PROPORTIONATE SHARE OF OPERATING  COSTS:  95% of the amount by 
which the  Operating  Costs (as defined in Section 3(a)) exceed $6.00 per 
rentable square foot.

     SEC. 2. BASE RENT AND CPI  INCREASE:    

     a. As part of the  consideration  for the  execution of this Lease,  Tenant
agrees to pay the Base  Rent,  payable  at the  office of  Landlord  in  monthly
installments  of  $335,092.75  each in legal  tender  of the  United  States  of
America, in advance,  without demand and without deduction,  on the first day of
each calendar month during the term hereof; provided, however, that if the Lease
Term  Commencement  Date is on a date  other  than the first  day of a  calendar
month,  the first rental  payment to be made on execution of this Lease shall be
the rental pro rated for the remainder of the calendar  month in which the Lease
Term  commences.  Such Base Rent shall be subject to  adjustments as hereinafter
provided.

     b. After the Initial Lease Year,
the amount of Base Rent due for such  Lease Year and each Lease Year  thereafter
shall  be  increased  by  the  percentage   increase  in  the  CPI  (as  defined
hereinafter)  last published prior to the first day of the then applicable Lease
Year and the CPI last published  prior to the first day of the prior Lease Year;
provided,  however,  in no event will the Base Rent  increase at a rate  greater
than four percent (4%) each Lease Year. The percentage increase in the CPI shall
be  calculated  and due from the first day of each Lease Year.  For  purposes of
this Lease,  the term CPI shall mean the Consumer  Price Index  published by the
Bureau of Labor Statistics of the United States  Department of Labor,  U.S. City
Average,  All Items and Major Group  Figures for Urban Wage Earners and Clerical
Workers  (1982-84 = 100), or if such index is not available,  a comparable index
selected by Landlord  which is  published  by a  governmental  institution  or a
nationally recognized publisher of statistical  information.  

     SEC. 3. ADDITIONAL RENT: 

     In addition to the Base Rent as specified in this Lease,  Tenant  agrees to
pay to Landlord as additional  rent  (Additional  Rent)  Tenant's  Proportionate
Share of Operating Costs.

                                       2


     a.  OPERATING  COSTS:  For the  purposes of  determining  Additional  Rent,
Operating  Costs shall  include,  without  limitation,  all costs,  expenses and
disbursements of every kind, nature and description paid or incurred by Landlord
relating  to (i)  the  management,  operation,  maintenance  and  repair  of the
Building and the land upon which the Building is located (the  Building and land
being  collectively  referred to  hereinafter  as the Property) and any personal
property used in connection therewith,  fixtures, machinery,  equipment, systems
and  apparatus  located  therein  or  used in  connection  therewith,  that  are
reasonably allocated by Landlord and which in accordance with generally accepted
accounting  principles,  are  considered  as an  expense of the  Property,  (ii)
charges for electricity,  power, gas, oil, water and other utilities used during
the Lease Term which are paid by Landlord to the utility service provider, (iii)
premiums  for  insurance  coverage,  (iv)  all  Impositions,  (v)  ordinary  and
necessary  repairs and maintenance of the Property and (vi) reasonable legal and
accounting  expenses,  all for a particular  calendar year or portion thereof as
determined  by Landlord  and  including  all  additional  costs and  expenses of
operation and  maintenance  of the Property which  Landlord  determines  that it
would  have  paid or  incurred  during  such year if the  Building  had been one
hundred  percent  (100%)   occupied.   For  purposes  of  determining   Tenant's
Proportionate  Share,  the  denominator  shall be the  Operating  Costs  for the
Property which shall be calculated in the aggregate and shall include all of the
parcels  comprising  the Property.  For purposes of this Section,  the following
shall not be included as Operating  Costs:  (i) payments  made by tenants of the
Building,  either to third parties or to Landlord,  under  agreements for direct
reimbursement  for  services  (e.g.,  separately  metered  utilities,   separate
contracted janitorial services,  property taxes directly reimbursed to Landlord,
etc.);  (ii) costs of  improvements to or alterations of space leased to tenants
other than Tenant or PhyCor, Inc. or their affiliates and the cost or expense of
any insurance  covering such  improvements  or  alterations in excess of the All
Risk casualty insurance carried by Landlord pursuant to Section 19 hereof; (iii)
depreciation  or amortization  of any  improvements  to the Property  (provided,
however,  that  Landlord  shall be  permitted  to  create as an  Operating  Cost
reasonable  reserves for major capital repairs so as to maintain the Property in
a first class  manner);  (iv) costs of repairing or restoring any portion of the
Building damaged by fire or other casualty for which Landlord recovers insurance
proceeds  sufficient  to  effect  such  repairs  and  restoration;  (v) costs of
repairs, alterations or replacements required as a result of the exercise of any
right of  eminent  domain to the  extent  Landlord  actually  recovers  from the
condemning  authority  condemnation  proceeds as a result of such  condemnation;
(vi) the cost of any special services  rendered to other tenants of the Property
which  are  not  rendered  to  Tenant;  (vii)  costs  of  selling,  syndicating,
financing,  mortgaging or hypothecating any part of or interest in the Property;
(viii) Landlord's overhead costs, including salaries, equipment,  supplies, rent
and other occupancy  costs or any other costs  associated with the operation and
internal  organization and function of Landlord as a business entity; (ix) costs
incurred as a result of  Landlord's  violation  of any lease,  contract,  law or
ordinance,  including  fines and fees  unless  such  violations  are caused by a
default of Tenant  hereunder;  (x) costs  related to any  building or land other
than the Property, including any allocation of costs incurred on a shared basis,
such  as  centralized  accounting  costs,  unless  the  allocation  is made on a
reasonable  and  consistent  basis that fairly  reflects the share of such costs
actually  attributable to the Property and unless such sharing of costs actually
reduces  Operating Costs; and (xi) the part of any cost or other sum paid to any
affiliate  of HR or to any other party that  exceeds a  Commercially  Reasonable
price or cost. 

     b. MONTHLY PAYMENT OF ESTIMATED  ADDITIONAL  RENT:  Tenant's  Proportionate
Share of Operating  Costs for the remainder of the calendar year after the Lease
Term Commencement Date and for each subsequent  calendar year shall be estimated
by Landlord  based on the preceding  year and any  anticipated  increases in the
services  and  expenses  deemed a part of Operating  Costs,  and written  notice
thereof  shall be given to Tenant.  Upon  receipt of said  written  notice  from
Landlord,  the  estimated  Additional  Rent  shall be due and  payable as herein
provided.  For any such  remainder  of the  calendar  year  after the Lease Term
Commencement  Date,  Tenant agrees to pay Landlord each month,  at the same time
the Base Rent is due, an amount  equal to the amount of such  estimated  monthly
Additional  Rent for the  remainder  of such  calendar  year;  and  during  each
calendar year  thereafter  Tenant agrees to pay Landlord each month, at the same
time  the  Base  Rent is due,  an  amount  equal to  one-twelfth  (1/12)  of the
estimated annual Additional Rent due. 

     c. ANNUAL  ADJUSTMENT  TO ADDITIONAL  RENT:  After the end of each calendar
year,  Landlord shall prepare and deliver to Tenant a statement showing Tenant's
total amount of  Additional  Rent  together  with a statement  showing  Tenant's
Proportionate  Share of Operating  Costs for such year.  Within thirty (30) days
after receipt of the aforementioned statement, Tenant agrees to pay Landlord, or
if Tenant has overpaid,  Landlord shall, at Tenant's  election either refund the
overpayment  to Tenant or credit  against the next  Additional  Rent  payment or
payments due from Tenant,  as the case may be, the difference  between  Tenant's
actual  Additional  Rent due for the  preceding  calendar year and the estimated
Additional Rent paid by Tenant during such year; provided,  however, that at the
end of the Lease Term or any renewal  period,  any overpayment by Tenant will be
refunded to Tenant within thirty (30) days of Landlord's  determination  of such
overpayment.

     Anything herein to the contrary notwithstanding, in no event will the Base
Rent provided  for in this Lease ever be reduced.

                                       3


     SEC. 4. RENT PAYMENT:  The Base Rent,  Additional  Rent, and all other sums
required to be paid by Tenant hereunder,  are sometimes collectively referred to
as, and shall  constitute,  Rent. 

     Rent shall be paid by Tenant when due,  without  prior demand  therefor and
without deduction or set off unless otherwise  specifically  provided herein, at
Landlord's address in Article XIII of the Lease  Administration  Agreement or at
such other place as Landlord may designated from time to time.

     In the event any installment of Base Rent,  Additional Rent or other amount
due from Tenant to Landlord  under this Lease shall not be paid when due, a late
charge  computed  at the Overdue  Rate (as  defined in the Lease  Administration
Agreement)  or the maximum  rate  permitted by law,  whichever  is less,  may be
charged by Landlord, as Additional Rent, for the purpose of defraying Landlord's
administrative  expenses incident to the handling of such overdue payments,  and
Tenant agrees to pay such Rent to Landlord upon demand. 

     SEC. 5.  PAYMENT FOR OTHER  SERVICES:  Tenant  agrees to pay to Landlord as
Rent all charges for any services,  goods, or materials furnished by Landlord at
Tenant's  request which are not required to be furnished by Landlord  under this
Lease, immediately upon receipt of Landlord's request for payment.

     SEC. 6. TENANT'S  OCCUPANCY AND USE: The Premises  shall be used solely for
the purpose of the Permitted Use in accordance with all applicable local,  state
and federal laws, rules and regulations. Tenant shall not permit any activity in
the Premises or take any action which would materially diminish the value of the
Property. Tenant covenants that it will obtain and maintain all approvals needed
to use and operate the Premises for the  Permitted Use under  applicable  local,
state and federal law.  Tenant  shall not commit or suffer to be  committed  any
waste on the Premises or the Property. 

     SEC. 7. LANDLORD'S RIGHT OF ACCESS: Landlord or its authorized agents shall
at any and all reasonable  times have the right to enter the Premises to inspect
the same,  to supply  janitorial  service or any other  service  Landlord  deems
necessary to provide hereunder,  to show the Premises to prospective  purchasers
or tenants, to alter, improve or repair the Premises or any other portion of the
Property all without  being  deemed  guilty of an eviction of Tenant and without
abatement  of  Rent,  and may for  that  purpose  erect  scaffolding  and  other
necessary  structures where reasonably  required by the character of the work to
be performed,  provided such activities of Landlord do not materially  interfere
with Tenant's business in the Premises. Subject to the foregoing,  Tenant hereby
waives any claim for damages for any injury or inconveniences to or interference
with  Tenant's  business,  any  loss of  occupancy  or  quiet  enjoyment  of the
Premises,  and any other  loss  occasioned  thereby.  For each of the  aforesaid
purposes, Landlord shall at all times have and retain a key with which to unlock
all of the doors in, upon and about the  Premises,  excluding  Tenant's  secured
medical  storage areas,  vaults and safes.  Landlord shall have the right to use
any and all means  which  Landlord  may deem  proper to open any  door(s)  in an
emergency without liability therefor. 

     SEC.  8.  QUIET  POSSESSION:  So long as  Tenant  pays  the  Rent  reserved
hereunder  and  observes  and  performs  all of the  covenants,  conditions  and
provisions on Tenant's part to be observed and performed hereunder, Tenant shall
have the quiet  possession  of the  Premises  for the entire  Lease Term hereof,
subject to all of the provisions of this Lease. 

                                       4


     SEC. 9. SERVICES AND  UTILITIES:  Provided  Tenant is not in default of any
term, condition or covenant of the Lease, Landlord will cause to be available in
the  Premises  gas (to the extent such is  accessible  to the  Property  from an
adjacent  public  right-of-way),  water (for  drinking,  cleaning  and  lavatory
purposes only), and electricity during the Lease Term. Tenant will contract for,
in its own name,  and will pay or cause to be paid all charges for  electricity,
power, oil, water, telephone and other utilities used in the Premises during the
Lease Term.  Landlord shall furnish  janitorial  service in a first class manner
during the periods and hours as may be agreed upon between  Landlord and Tenant;
provided,  however,  that  Tenant  recognizes  that there  will be a  transition
period,  not to exceed  forty-five (45) days, after the Lease Term  Commencement
Date during which  Landlord and Tenant will mutually work toward the  assumption
of these services by Landlord.  Landlord shall  furnish,  as an Operating  Cost,
routine  maintenance,  painting  and  lighting  service for all public areas and
special  service  areas  of the  Building  in a first  class  manner;  provided,
however,  that Tenant recognizes that there will be a transition  period, not to
exceed forty-five (45) days, after the Lease Term Commencement Date during which
Landlord and Tenant will mutually work toward the  assumption of these  services
by Landlord.  Landlord shall not be liable in damages,  direct or consequential,
or otherwise for failure,  stoppage or interruption of any such service, so long
as such failure,  stoppage or interruption is not caused by the gross negligence
or willful misconduct of Landlord, its agents or employees;  provided,  however,
that any such  failure,  stoppage or  interruption  shall not be construed as an
eviction  of Tenant,  work an  abatement  of rent,  or relieve  Tenant  from the
operation  of any  covenant  or  agreement.  In the  event of any such  failure,
stoppage or  interruption  thereof,  Landlord shall use reasonable  diligence to
resume service promptly. 

     SEC. 10.  REPAIRS AND  MAINTENANCE:  Landlord  shall provide or cause to be
provided  cleaning  and  maintenance  of the public  portions  of the  Building,
including  painting and  landscaping  surrounding  the Building in a first class
manner;  provided,  however,  that  Tenant  recognizes  that  there  will  be  a
transition  period,  not to exceed  forty-five  (45) days,  after the Lease Term
Commencement Date during which Landlord and Tenant will mutually work toward the
assumption of these  services by Landlord.  Unless  otherwise  expressly  stated
herein,  Landlord shall not be required to make any  improvements  or repairs of
any kind or character in the Premises during the Lease Term, except such repairs
as may be  required  by  normal  maintenance  operations,  which  shall  include
structural repairs to the outside exterior walls,  corridors,  windows, roof and
other  structural  elements and equipment of the Building,  and such  additional
maintenance as may be necessary because of damages by persons other than Tenant,
its agents, employees,  invitees or visitors.  

     Landlord  may at its  option  and at the sole cost and  expense  of Tenant,
repair or replace any damage or injury done to the Building or any part thereof,
solely caused by Tenant,  Tenant's  agents,  employees,  licensees,  invitees or
visitors,  reasonable wear and tear excepted.  Tenant shall pay the cost of such
repairs plus a fifteen percent (15%)  administrative  fee to Landlord on demand.
Tenant  further agrees to maintain and keep the interior of the Premises in good
repair and condition at Tenant's  expense.  Tenant agrees not to commit or allow
any waste or damage to be committed on any portion of the  Premises,  and at the
termination  of this  Lease,  by lapse of time or  otherwise,  to deliver up the
Premises  to  Landlord  in as good  condition  as they  existed  on the  date of
possession by Tenant,  ordinary wear and tear alone excepted, and Landlord shall
have the right to re-enter and resume  possession of the Premises whether or not
the Premises are vacated by Tenant. 

     All requests for repairs and  maintenance  that are the  responsibility  of
Landlord  pursuant  to any  provision  of this  Lease must be made in writing to
Landlord at the address set forth herein,  or as subsequently  changed from time
to time by Landlord in writing. Landlord shall provide sufficient staff so as to
be  responsive  to  Tenant's   requests  for  normal  and  routine  repairs  and
maintenance. All normal and routine repairs requested by Tenant shall be made by
Landlord promptly and in any event within twenty-four (24) hours after receiving
such request;  provided,  however,  that Tenant  recognizes that there will be a
transition  period,  not to exceed  forty-five  (45) days,  after the Lease Term
Commencement Date during which Landlord and Tenant will mutually work toward the
assumption  of these  services  by  Landlord.  

     SEC. 11.  TENANT'S  ALTERATIONS,  FIXTURES AND  PERSONAL  PROPERTY:  Tenant
covenants  and  agrees  that  it  will  make  no  structural  change,   interior
alterations  or additions that will in the  reasonable  determination  of Tenant
materially  change the general  design or  structural  integrity of the Building
without  Landlord's  written  consent in  advance,  which  consent  shall not be
unreasonably  withheld,  and without first  furnishing the Landlord fifteen (15)
days advance  notice  outlining in detail the proposed  changes or  alterations.
Landlord  shall grant or withhold its consent  within seven (7) business days of
receipt of such a request from Tenant. 

     Any such changes,  interior  alterations  or additions  (including  but not
limited to wall-to-wall  carpeting,  paneling and other wall coverings) approved
in writing by Landlord shall be surrendered to Landlord upon termination of this
Lease, Tenant hereby waiving all rights to any payment or compensation therefor.
All  costs  and  expenses  of any  approved  changes,  interior  alterations  or
additions  shall be borne solely by Tenant which  payment shall be made in cash,
unless  Landlord and Tenant mutually  agree,  that such changes,  alterations or
additions  shall be  treated  as a Capital  Addition  (as  defined  in the Lease
Administration  Agreement)  and treated in accordance  with the Article V of the
Lease   Administration   Agreement.   Any   contractor  or  person  making  such
improvements for Tenant must first be approved in writing by Landlord. 

     Tenant may remove  its trade  fixtures,  office  supplies,  movable  office
furniture or equipment and other personal  property not attached to the Building
during the Lease Term or within  thirty (30) days  following  the  expiration or
earlier  termination  of the Lease provided that Tenant is not in default of any
obligation  or  covenant  under this Lease at the time of such  removal and that
Tenant promptly repairs all damage caused by such removal. 

                                       5


     SEC.  12.  CONDITION  OF THE  PREMISES:  Tenant  acknowledges  receipt  and
delivery  of  possession  of the  Premises  and that  Tenant  has  examined  and
otherwise  has a acquired  knowledge of the  condition of the Premises  prior to
execution  and delivery of this Lease and has found the same to be in good order
and repair and  satisfactory  for its purpose  hereunder.  Tenant is leasing the
Premises  as is in its  present  condition.  Tenant  waives  any claim or action
against Landlord in respect of the condition of the Premises.  LANDLORD MAKES NO
WARRANTY OR REPRESENTATION,  EXPRESS OR IMPLIED, IN RESPECT OF THE PROPERTY, THE
PREMISES OR ANY PART  THEREOF,  EITHER AS TO ITS  FITNESS FOR USE,  SUITABILITY,
DESIGN OR  CONDITION  FOR ANY  PARTICULAR  USE OR  PURPOSE OR  OTHERWISE,  AS TO
QUALITY OF THE  MATERIAL  OR  WORKMANSHIP  THEREIN,  LATENT OR PATENT,  IT BEING
AGREED THAT ALL SUCH RISKS ARE TO BE BORNE BY TENANT.  TENANT  ACKNOWLEDGES THAT
THE PREMISES HAS BEEN INSPECTED BY TENANT AND IS SATISFACTORY TO IT. 

     SEC.  13. LIENS BY TENANT:  Tenant  shall keep the  Premises  free from any
liens arising out of any work  performed,  materials  furnished,  or obligations
incurred by or for Tenant.  In the event that Tenant shall not,  within  fifteen
(15)  days  following  the  imposition  of any such  lien,  cause the same to be
released of record by payment or posting of a proper bond,  Landlord shall have,
in addition to all other remedies  provided herein and by law, the right but not
the obligation,  to cause the same to be released by such means as it shall deem
proper,  including  payment of or defense  against the claim giving rise to such
lien.  All sums paid by Landlord and all expenses  incurred by it in  connection
therewith shall create  automatically an obligation of Tenant to pay, on demand,
an  equivalent  amount  together  with  interest at a rate of the Prime Rate (as
defined in the Lease  Administration  Agreement) plus two percent (2%) per annum
as Rent. No work which Landlord  permits Tenant to perform in the Premises shall
be  deemed  to be for the  immediate  use and  benefit  of  Landlord  so that no
mechanics  or other lien  shall be allowed  against  the estate of  Landlord  by
reason of its consent to such work. 

     SEC. 14. SUBLETTING AND ASSIGNING:  Tenant shall not sublet the Premises or
any part  thereof.  Tenant  shall not assign this Lease in whole or in part,  by
operation of law or otherwise,  or mortgage or pledge the same without the prior
written  consent of  Landlord  and in no event  shall any such  assignment  ever
release  Tenant from any obligation or liability  hereunder.  No assignee of the
Premises or any portion thereof may assign the Premises or any portion  thereof.
Landlord  shall not be required to collect any rents or other  payments from any
party  on  behalf  of  Tenant's  account;  provided,  however,  that  Landlord's
collection  and acceptance of such payments shall not be construed to constitute
a novation or a release of Tenant from further  performance  of its  obligations
under this Lease. Notwithstanding the foregoing, Landlord shall not unreasonably
withhold  or  delay  its  consent  to  Tenant's  merger  or  consolidation  with
affiliates of Tenant or affiliates of PhyCor,  Inc. or other  entities  provided
that the use of the Premises  remains in  conformity  with the Permitted Use and
the creditworthiness of the proposed assignee is equal to or better than that of
Tenant, in Landlord's sole reasonable discretion. In the event Tenant desires to
assign the Lease to PhyCor,  Inc.  or an  affiliate  of PhyCor,  Inc.,  Landlord
agrees to execute a direct lease with  PhyCor,  Inc. or its  affiliate  upon the
same terms and  conditions  of this  Lease;  provided,  however,  that any space
leased to PhyCor,  Inc. or its  affiliates  shall at all times be deemed  Clinic
Space (as  defined in the Lease  Administration  Agreement).  

                                       6


     SEC.  15. FIRE AND  CASUALTY:  In the event the Premises or the Building is
partially or totally  destroyed or damaged by fire or other casualty,  the terms
and provisions of Article VII of the Lease Administration Agreement shall govern
this Lease.  Notwithstanding anything herein to the contrary, Landlord shall not
be obligated in any way or manner to insure any  personal  property  (including,
but not limited  to, any  fixtures,  furniture,  machinery,  goods,  supplies or
improvements)  of Tenant or which Tenant may have upon or within the Premises or
any  fixtures  installed  by or paid for by Tenant upon or within the  Premises.

     SEC.  16.  WAIVER  OF  SUBROGATION:  Provided  their  respective  insurance
carriers  will consent and agree,  Landlord  and Tenant  hereby waive any rights
each may have against the other, on account of any loss or damage  occasioned to
Landlord or Tenant, as the case may be, their respective property, the Premises,
its  contents  or to the other  portion of the  Property  arising  from any risk
covered by valid and enforceable fire and extended  coverage  insurance,  to the
extent of such coverage.  Landlord and Tenant each agree to cause an endorsement
to be furnished to their respective  insurance policies  recognizing this waiver
of subrogation. 

     SEC. 17. DEFAULT BY TENANT: 

     a. The occurrence of any of the following shall constitute a material
default and breach of this Lease by Tenant (hereinafter referred to as an Event
of Default):  

        i.   Any failure by Tenant to pay Rent or to make any other payment
             required to be made by Tenant  hereunder  when due; 

        ii.  Any failure by Tenant to observe  and  perform  any other provision
             of this Lease to be observed or performed  by Tenant,  where such 
             failure  continues  for thirty (30) days after written notice to 
             Tenant (unless such failure cannot be cured within thirty (30)
             days and Tenant shall have commenced to cure said  failure  within
             said thirty (30) days and continues diligently to pursue the curing
             of the same);

        iii. An event of default shall occur under the Lease Administration  
             Agreement or any of the Property Leases (as defined in the Lease 
             Administration Agreement). 

     b. If an Event of Default shall have  occurred,  Landlord shall have at its
election, then or at any time thereafter, the right to pursue any one or more of
the remedies available to Landlord under Article IX of the Lease  Administration
Agreement. 

     c. Landlord shall give Tenant and PhyCor,  Inc. written notice of any Event
of Default  within  fifteen (15) business days of the occurrence of the same, at
the  addresses  set forth in Section 36. 

     SEC. 18. DEFAULT BY LANDLORD:  Except as otherwise  provided in this Lease,
Landlord  shall be in default under this Lease if Landlord  fails to perform any
of its obligations  hereunder and said failure  continues for a period of thirty
(30) days after  written  notice  thereof  from Tenant to Landlord  (unless such
failure  cannot  reasonably be cured within thirty (30) days and Landlord  shall
have  commenced to cure said failure  within said thirty (30) days and continues
diligently to pursue the curing of the same).  In no event shall Tenant have the
right to levy execution against any property of Landlord other than its interest
in the Building. 

                                       7


     SEC. 19. INSURANCE:
     
     a. GENERAL INSURANCE  REQUIREMENTS.  During the Lease Term, Landlord, as an
Operating Cost,  shall at all times keep the Property and the Premises,  insured
with the kinds and amounts of insurance described below. All such policies shall
be issued by insurance  companies  licensed to do business in the state in which
the  Property  is  located,  with a rating of A-IX or better as  established  by
Best's Rating Guide (or an equivalent rating approved by Landlord). The policies
on the Property and the Premises  shall insure against the following  risks:

        i. Loss or damage  by fire, vandalism and malicious  mischief,  extended
     coverage  perils  commonly known as All Risk and all  physical loss perils,
     including but not limited  to  sprinkler  leakage,  windstorm, hail, flood,
     earthquake (when the Property is located in whole or in part  within a zone
     designated at risk for earthquakes), tornado, hurricane and similar damage,
     in an amount not less than one hundred percent (100%) of the then Full  
     Replacement Cost thereof (as defined below) with a replacement cost 
     endorsement sufficient to prevent Landlord from becoming a co-insurer  
     together with an agreed value endorsement; 

        ii.  Loss or damage by explosion of steam boilers,  pressure  vessels or
     similar apparatus,now or hereafter installed in the Property,in such limits
     with respect to any one accident as may be  reasonably  desired by Landlord
     from time to time; 

        iii. Business interruption or loss of rental under a rental value 
     insurance policy  covering  risk of loss during the first twenty-four (24)
     months of reconstruction necessitated by the occurrence of any of the 
     hazards described in Sections 19(a)(i)or 19(a)(ii), in an amount sufficient
     to prevent Landlord from becoming a co-insurer; 

        iv.  Claims for personal injury or  property  damage  under a policy of
     comprehensive general public liability insurance, including but not limited
     to, insurance  against  assumed or contractual  liability  including any 
     indemnities under this Lease with an amount not less than Five Million 
     Dollars ($5,000,000) per occurrence for injury to or death of persons 
     and/or property damage; and 

        v. Flood (when the Property is located in whole or in part within a zone
     designated at risk for floods) and such other hazards and in such amounts 
     as may be customary for comparable properties in the area and if available
     from insurance companies authorized to do business in the state in which 
     the Property is located at rates which are economically practicable in 
     relation to the risks covered. 

     b. REPLACEMENT  COST. The term Full Replacement Cost as used herein,  shall
mean the  greater  of (i) actual  replacement  cost  thereof  from time to time,
including increased cost of construction endorsement, or (ii) the purchase price
paid by Landlord for the Property at the time of such acquisition (together with
all capitalized  costs related to such acquisition) plus capital addition costs,
less  exclusions  provided in the normal  fire  insurance  policy.  In the event
either Landlord or Tenant believes that the Full  Replacement Cost has increased
or decreased at any time during the Lease Term,  it shall have the right to have
such Full Replacement Cost  redetermined by the fire insurance  company which is
then  providing the largest  amount of fire  insurance  carried on the Property,
hereinafter referred to as the impartial  appraiser.  The party desiring to have
the Full  Replacement Cost so redetermined  shall forthwith,  on receipt of such
determination  by such impartial  appraiser,  give written notice thereof to the
other party hereto. The determination of such impartial appraiser shall be final
and binding on the parties hereto, and Landlord shall forthwith, as an Operating
Cost, increase, or may decrease, the amount of the insurance carried pursuant to
this  Section,  as the case may be, to the amount so determined by the impartial
appraiser.  Landlord,  as an Operating  Cost,  shall pay the fee, if any, of the
impartial appraiser.

                                       8


     c. WORKMANS COMPENSATION INSURANCE. In addition to the insurance described
above,  Landlord,  as  an  Operating  Cost,  shall  maintain  adequate  worker's
compensation  insurance  coverage  for all  persons  employed by Landlord on the
Property, if any, in accordance with the requirements of applicable local, state
and federal law.

     d.  INCREASE  IN  LIMITS.  In the  event  that  Landlord  shall at any time
reasonably  deem the limits of the personal  injury,  property damage or general
public liability  insurance then carried to be insufficient  based on commercial
insurance  standards  for  similar  properties  or  the  advice  of  independent
insurance  advisers,  such insurance  shall  thereafter be increased and carried
with the new limits until  further  changed  pursuant to the  provisions of this
Section.

     e. BLANKET POLICY.  Notwithstanding  anything to the contrary  contained in
this  Section,  obligations of the Landlord and Tenant to carry  the  insurance
provided for herein may be brought  within the  coverage of a so-called  blanket
policy or policies of insurance carried and maintained by Landlord or Tenant, as
the case may be,  provided,  that any such  blanket  policy  or  policies  shall
otherwise satisfy the insurance requirements of this Section.

     f. LIABILITIES.  Notwithstanding  the foregoing,  and without regard to the
policy  limits  of any  such  insurance  or  self  insurance,  all  liabilities,
obligations,  claims, damages,  penalties,  causes of action, costs and expenses
(including,  without  limitation,  reasonable  attorneys'  fees  and  expenses),
imposed  upon or  incurred  by or asserted  against Landlord  by reason  of any
accident,  injury to or death of persons  occurring  on or about the Property or
adjoining  sidewalks but excluding any claims arising from the gross  negligence
or willful misconduct of Landlord,  its employees or agents,  shall be deemed to
be an Operating Cost.

     g.  TENANT'S  INSURANCE  OBLIGATIONS.  During the Lease Term,  Tenant shall
maintain (i) adequate worker's  compensation  insurance coverage for all persons
employed by Tenant on the  Property,  in  accordance  with the  requirements  of
applicable  local,  state and federal law; (ii) insurance against claims arising
out of malpractice in an amount not less than Five Million Dollars  ($5,000,000)
for each person and Ten Million Dollars  ($10,000,000) for each occurrence;  and
(iii)  claims  for  personal  injury  or  property  damage  under  a  policy  of
comprehensive general public liability insurance,  including but not limited to,
insurance  against  assumed or contractual  liability  including any indemnities
under this Lease with an amount not less than Five Million Dollars  ($5,000,000)
per  occurrence  for injury to or death of persons and/or  property  damage.  If
Tenant shall engage or cause to be engaged any contractor to perform work on the
Premises,  Tenant shall require such  contractor  to carry and  maintain,  at no
expense to Landlord,  non-deductible  comprehensive general liability insurance,
including  but  not  limited  to  contractor's  liability  coverage,   completed
operations  coverage,  broad form property damage  endorsement and  contractor's
protection  liability  coverage  in such  amounts  and with  such  companies  as
Landlord  shall  approve.  Tenant  shall,  upon request by Landlord,  furnish to
Landlord policies or certificates  evidencing such coverage,  which certificates
shall state that such insurance coverage may not be changed or cancelled without
at least thirty (30) days prior  written  notice to Landlord and Tenant.  All of
the policies of insurance  referred to in this Section 19(g) shall be written in
form  satisfactory  to Landlord  and by  insurance  companies  authorized  to do
insurance  business  in the  state in  which  the  Property  is  located  and by
insurance companies  satisfactory to Landlord.  The insurance policies must name
Landlord as an  additional  insured.  In the event  Tenant shall fail to procure
such  insurance,  Landlord may at its option procure the same for the account of
Tenant,  and the cost thereof shall be paid to Landlord as Additional  Rent upon
receipt by Tenant of bills therefor.

     SEC. 20.  ATTORNEY'S  FEES:  In the event of any legal action or proceeding
brought  by either  party  against  the other  arising  out of this  Lease,  the
prevailing  party shall be entitled to recover  reasonable  attorney's  fees and
costs  incurred in such action and such amount shall be included in any judgment
rendered in such proceeding.

     SEC.  21.  CONDEMNATION:  In the event the  Property or the Building or any
portion  thereof  shall  be taken or  condemned  in whole or in part for  public
purposes,  or sold to a condemning  authority to prevent taking,  then the terms
and  provisions  of Article  VIII of the Lease  Administration  Agreement  shall
govern and control. 

                                       9


     SEC. 22. PAYMENT OF  IMPOSITIONS:  Landlord will pay, or cause to be paid,
all Impositions. 

     SEC. 23.  TAXES ON TENANT'S PROPERTY: Tenant shall be liable for and shall
pay,  prior to their  becoming  delinquent, any and all taxes and assessments 
levied against any personal property or trade or other fixtures placed by 
Tenant in or about the Premises.  

     SEC. 24. SIGNS: No signs of any kind or nature,  symbol or identifying mark
shall be put on the Building, the Property, in the halls, elevators, staircases,
entrances,  parking  areas or upon the doors or walls,  whether  plate  glass or
otherwise,  of the Premises nor within the Premises so as to be visible from the
public areas or exterior of the  Building,  without  prior  written  approval of
Landlord.  All signs of  lettering  shall  conform in all  respects  to the sign
and/or  lettering  criteria   established  by  Landlord.   

     SEC. 25.  RULES AND  REGULATIONS:  Such  reasonable  rules and  regulations
applying  to all  Tenants in the  Building  as may be adopted  by  Landlord  and
approved by Tenant, for safety, care,  cleanliness,  preservation of good order,
or operation of the Premises,  the Building and the Property,  are hereby made a
part  hereof and Tenant  agrees to comply  with all such rules and  regulations.
Such rules and  regulations  adopted by Landlord and approved by Tenant shall be
thereafter  carried out and observed by Tenant.  

     SEC. 26.  HOLDING OVER: In the event Tenant,  or any party  claiming  under
Tenant,  retains  possession  of the Premises  after the  expiration  or earlier
termination  of this  Lease,  such  possession  shall be a tenancy at will under
applicable law. Tenant shall be subject to immediate  eviction and removal,  and
Landlord,  in addition to all other  remedies  available to it hereunder,  shall
have the right to receive as liquidated damages for all the time Tenant shall so
retain possession of the Premises or any part thereof,  an amount equal to twice
the Base Rent  specified in the Lease,  as applied to such period  together with
all other payments required  hereunder as Additional Rent. 

     Tenant  shall also pay any and all damages,  including  but not limited to,
consequential  damages  sustained  by  Landlord  as a result of such  hold-over.
Tenant will vacate the Premises and deliver  same to Landlord  immediately  upon
Tenant's  receipt  of  notice  to do so from  Landlord.  The  Rent  during  such
hold-over  period  shall be payable to  Landlord on demand.  No holding  over by
Tenant, whether with or without consent of Landlord, shall operate to extend the
Lease Term. 

     SEC. 27.  NON-WAIVER:  No waiver by Landlord of any provision of this Lease
or of any breach by Tenant hereunder shall be deemed to be a waiver of any other
provision hereof, or of any subsequent breach by Tenant of the same or any other
provision.  Landlord's  consent to or  approval  of any act by Tenant  requiring
Landlord's  consent or approval  shall not be deemed to render  unnecessary  the
obtaining of Landlord's  consent to or approval of any subsequent act of Tenant.
No act or thing done by Landlord or  Landlord's  agents  during the term of this
Lease shall be deemed an acceptance of a surrender of the Premises,  unless done
in writing signed by Landlord.  The acceptance of any Rent by Landlord following
a breach of this Lease by Tenant  shall not  constitute  a waiver by Landlord of
such  breach or any other  breach  unless  such  waiver is  expressly  stated in
writing signed by Landlord.

     SEC. 28.  SUBORDINATION  AND ATTORNMENT:

     a. This Lease shall be subject to and  subordinate to any lease  (including
ground  lease)  wherein  Landlord  is the  tenant and to the lien of any and all
mortgages  or deeds of trust,  regardless  of whether  such lease,  mortgages or
deeds of trust now exist or may  hereafter  be created with regard to all or any
part of the Building or the Property, or both, and to any and all advances to be
made  thereunder,   and  to  the  interest  thereon,   and  all   modifications,
consolidations,  renewals,  replacements,  and extensions  thereof.  Tenant also
agrees  that any lessor or  mortgagee  may elect to have this Lease prior to any
lease  or  lien of its  mortgage  or deed of  trust,  and in the  event  of such
election  and upon  notification  by such lessor or  mortgagee to Tenant to that
effect,  this  Lease  shall be  deemed  prior  to the said  lease or lien of its
mortgage or deed of trust, whether this Lease is dated prior to or subsequent to
the date of said lease, mortgage or deed of trust. 

     b. In the event of the sale or  assignment  of  Landlord's  interest in the
Premises  (except in a sale - leaseback  financing  transaction),  Tenant  shall
attorn to and  recognize  such  purchaser  or assignee or  mortgagee as Landlord
under this  Lease,  provided  that the  transferee  or  assignee  assumes all of
Landlord's  obligations  hereunder and provided further that Tenant shall not be
disturbed in its possession so long as it is not in default hereunder. 

     c. In the  event of any  proceedings  brought  for the  foreclosure  of any
mortgage or deed of trust covering the Property, or in the event of the exercise
of a power of sale pursuant  thereto and upon the written request of a purchaser
at such foreclosure proceedings, Tenant shall, at the request of such purchaser,
attorn to and recognize such  purchaser as Landlord  under this Lease,  provided
that the transferee or mortgagee assumes all of Landlord's obligations hereunder
and provided  further that Tenant  shall not be disturbed in its  possession  so
long as it is not in default hereunder.  

     d. Tenant agrees that, upon the request of Landlord,  or any such lessor or
mortgagee,  Tenant shall execute and deliver whatever instruments may reasonably
be required for such purposes in order to carry out the intent of this Section.

                                       10


     SEC. 29. TRANSFER OF LICENSES:  Upon the expiration or earlier  termination
of the Lease Term,  Tenant shall use its best efforts to transfer (to the extent
legally  transferable)  to Landlord or Landlord's  nominee,  without  additional
consideration  to Tenant,  all licenses (except  Tenant's  operating  licenses),
operating  permits  and other  governmental  authorizations  and all  contracts,
including contracts with governmental or  quasi-governmental  entities which may
be necessary or useful in the operation of the Property.

     SEC.  30.  SUCCESSORS  AND ASSIGNS:  Except as  otherwise  provided in this
Lease,  all of the  covenants,  conditions and provisions of this Lease shall be
binding  upon and shall  inure to the  benefit of the  parties  hereto and their
respective successors and permitted assigns.

     SEC. 31. TIME: Time is of the essence.  

     SEC. 32. APPLICABLE LAW: This Lease shall be governed by and construed  
pursuant to the laws of the Commonwealth of Virginia.   

     SEC. 33.  SEVERABILITY:  If any provision of this Lease or the  application
thereof to any person or circumstances  shall be invalid or unenforceable to any
extent,  the remainder of this Lease and the  application of such  provisions to
other  persons  or  circumstances  shall not be  affected  thereby  and shall be
enforced to the greatest extent permitted by law.

     SEC. 34.  AUTHORITY OF TENANT:  If Tenant or Landlord,  as the case may be,
executes  this Lease in other than an individual  capacity,  each of the persons
executing  this Lease on behalf of Tenant or Landlord,  as the case may be, does
hereby personally covenant and warrant that Tenant or Landlord,  as the case may
be, is a duly authorized and existing legal entity as herein  represented,  that
Tenant or  Landlord,  as the case may be, has and is qualified to do business in
the State in which the Building is located,  that the Tenant or Landlord, as the
case may be, has full right and  authority  to enter into this  Lease,  and that
each person signing on behalf of the Tenant or Landlord,  as the case may be, is
authorized  to  do  so.  Upon  request  the  signatories   hereto  will  furnish
satisfactory  evidence of their authority to execute this Lease on behalf of the
respective parties.

     SEC. 35. BROKERS:  Tenant and Landlord warrant to the other that it has had
no  dealings  with any real  estate  broker  or  agent  in  connection  with the
negotiation  of this Lease,  and that it knows of no real estate broker or agent
who might be entitled to a commission in connection with this Lease.  Tenant and
Landlord  agree to indemnify  and hold harmless the other party from and against
any liability from all other claims for commissions arising from the negotiation
of this Lease.

                                       11


     SEC. 36. NOTICES: All notices which Landlord or Tenant may be required,  or
may  desire,  to serve on the other  shall be in writing  and shall be served or
delivered in accordance  with the provisions  and to the addresses  specified in
Article XIII of the Lease Administration  Agreement.  All notices which Landlord
or Tenant may be required,  or may desire, to serve on PhyCor,  Inc. shall be in
writing and shall be either (a) delivered in person, (b) sent by certified mail,
return receipt requested,  (c) delivered by a recognized  delivery service which
takes a receipt on delivery or (d) sent by facsimile  transmission and addressed
as follows:

            PhyCor, Inc.: PhyCor, Inc.
                          30 Burton Hills Boulevard, Suite 500 
                          Nashville,  Tennessee 37215 
                          Attn: President
                          Phone:  (615)  665-9066 
                          Fax:  (615) 665-9088
            
            With a copy to: William E. Shofner, Esq.
                          Waller,  Lansden,  Dortch & Davis 
                          511 Union Street,  Suite 2100 
                          Nashville, Tennessee  37219-1760  
                          Phone: (615) 244-6380  
                          Fax: (615)  244-6804  

     SEC.  37.  RELATIONSHIP  OF  LEASE  TO  LEASE   ADMINISTRATION   AGREEMENT:
Notwithstanding any provision herein to the contrary, no provision in this Lease
shall be  construed  or  interpreted  to limit or abrogate  any of the terms and
provisions  of the  Lease  Administration  Agreement.  In the  event any term or
provision  of this Lease shall  contradict  any term or  provision  in the Lease
Administration  Agreement,  the Lease Administration  Agreement shall govern and
control. 

     SEC. 38. ENTIRE AGREEMENT: Except for the terms and provisions of the Lease
Administration  Agreement,  this Lease  contains  all of the  agreements  of the
parties hereto with respect to this Lease, and no prior agreement, understanding
or  representation  pertaining  to any such matter  shall be  effective  for any
purpose.  No  provision  of this  Lease may be  amended or added to except by an
agreement in writing signed by the parties hereto or their respective successors
in interest. 

                                       12


     SEC.  39.  COUNTERPARTS:  This  Agreement  may be  signed  in  one or  more
counterparts,  duplicate  signature pages or facsimile signature pages, with the
same force and effect as if all required  signatures  were contained in a single
original instrument.  Any one or more of such counterparts,  duplicate signature
pages or facsimile  signature pages may be removed from any one or more original
copies of this Agreement and annexed to other counterparts,  duplicate signature
pages or  facsimile  signature  pages  to form a  completely  executed  original
instrument.

     IN WITNESS WHEREOF, the parties have caused  this Lease to be executed  by 
their respective duly authorized officers.  

TENANT:                                   LANDLORD:
LEWIS-GALE CLINIC, L.L.C.                 HRT OF ROANOKE, INC.

By:________________________________       By:________________________________

Print Name: _______________________       Print Name:________________________

Its________________________________       Its:_______________________________ 

                                     
                                     13


                                  EXHIBIT "A"
                              PROPERTY DESCRIPTION

LEWIS-GALE CLINIC 

PARCEL I                       TRACT I (0.432 AC) 

Being a tract of land situated in Salem,  Virginia and  designated as Tract I,
containing 0.432 acre of land and designated as tax #303-1-2.

COMMENCING at corner #1, said corner #1
being the  intersection  of the  property of Lewis Gale  Hospital as recorded in
Deed Book 4, Page 176 (Tax  #283-2-1) and Tract IIB, said corner #1 lying on the
northerly  right-of-way  line of Keagy  Road (50'  R/W);  

Thence  along the line common to said  property of Lewis Gale  Hospital and
Tract IIB, the following  courses and  distances,  N 22(Degree) 56' 30 E. 212.01
feet to a point; 

Thence S 67(Degree)  03' 30 E.  5.66  feet to the  Actual  Point of  BEGINNING;

Thence S 67(Degree)  03' 30 E. 37.84 feet along the line common to said property
of Lewis Gale  Hospital,  Inc.  and  property  herein  described  to a  point;  

Thence  N 22(Degree)  56' 30 E. 88.58 feet along  said  common  line to a point;

Thence S 67(Degree) 03' 30 E. 7.65 feet along the line common to aforesaid Tract
IIB and the property  herein  described to a point;

Thence N 22(Degree) 56' 30 E. 35.20 feet along said common line to a point; 

Thence S 67(Degree) 03' 30 E. 79.00 feet along said  common  line to a point;  

Thence S  22(Degree)  56' 30 W. 35.20 feet along the line  common  to Tract IIA
(tax  parcel  #303-1-2.1) and the  herein described  tract;

Thence along said common line the following courses and distances, S 67(Degree)
03' 30 E. 17.05 feet to a point; 

Thence S 22(Degree) 56' 30 W.  73.80  feet to a point;  

Thence N  67(Degree)  03' 30 W. 16.97 feet to a point;  

Thence S 22(Degree) 56' 30 W. 33.20 feet to a point; 

Thence S 67(Degree) 03' 30 E. 16.97 feet to a point;  

Thence S 22(Degree)  56' 30 W. 55.02 feet to a point;  

Thence N 67(Degree) 03' 30 W. 54.35 feet along the line common to property of 
Lewis Gale Medical  Foundation  as recorded in Deed Book 26, Page 77
(tax #303-1-1) and the herein described property;  

Thence N 22(Degree) 56' 30 E.13.02 feet along the line common to the 
aforementioned Tract IIB and the herein described property;  

                                       14


Thence along said common line for the following courses and distances,
N 67(Degree) 03' 30 W. 51.00 feet to a point; 

Thence N 22(Degree) 56' 30 E. 45.44 feet to a point; 

Thence N 67(Degree) 03' 30 W. 7.07 feet to a point; 

Thence N 22(Degree)  56' 30 E. 6.51 feet to a point;

Thence N 67(Degree) 03' 30 W. 29.12 feet to a point;  

Thence N 22(Degree) 56'30 E. 8.47 feet to the Point of BEGINNING and  containing
a computed  acreage of 0.432 acre (18.829 sq. ft.) 

Together with appropriate non-exclusive easements of ingress and egress over and
along private roads (now  existing or as may  hereafter be  constructed  and/or
relocated) of Lewis-Gale Hospital, Incorporated, running across its remaining 
lands connecting the subject property to Keagy Road and Braeburn Drive.

Together also with easements for general utility purposes over, across and
under remaining  properties of  Lewis-Gale  Hospital,  Incorporated, including
water, sewer, drainage, electricity, gas and telephone, such easements to be
reasonable  and to be  exactly  located  as might  be  mutually  agreed  upon by
Lewis-Gale Hospital,  Incorporated,  and Industrial Development Authority of the
City of Salem, Virginia, their successors and assigns.  

PARCEL I - continued        TRACT II-B (3.032 AC) 

Being a tract of land situated in Salem,  Virginia, and designated as Tract
IIB and containing 3.032 acres of land.

BEGINNING at corner #1, a point located on the northerly  right-of-way line
of Keagy Road (50' R/W) and being the corner  common to  property  of Lewis Gale
Hospital, Inc. as recorded in Deed Book 4, Page 176 (tax number 283-2-1) and the
herein described parcel;

Thence  along the line common to said  property of Lewis Gale  Hospital and the 
herein described parcel, N 22(Degree) 56' 30 E. 212.01 feet to a point;

Thence S 67(Degree) 03' 30 E. 5.66 feet along said common line to a point;

Thence along the line common to Tract I (tax #303-1-2) and the herein described
parcel, the following courses and distances,  S 22(Degree) 56' 30 W. 8.47 feet 
to a point;

Thence S 67(Degree) 03' 30 E. 29.12 feet to a point;

Thence S  22(Degree)  56' 30 W. 6.51 feet to a point;

Thence S 67(Degree) 03' 30 E. 7.07 feet to a point;

Thence S 22(Degree) 56' 30 W. 45.44 feet to a point;

Thence S 67(Degree)  03' 30 E. 51.00 feet to a point;

Thence S  22(Degree)  56' 30 W. 13.02 feet to a point;

                                       15


Thence along the line  common to property of Lewis Gale  Medical  Foundation as
recorded in Deed Book 26, Page 77 (tax  parcel  #303-1-1) and the herein 
described  parcel the following  courses and  distances,  N 67(Degree) 03' 30 W
48.35 feet to a point;

Thence S 22(Degree) 56' 30 W. 110.58 feet to a point;

Thence S 71(Degree) 03' 15 E. 137.51 feet to a point;

Thence N 22(Degree) 56' 30 E. 78.40 feet to a point;

Thence  along  the line  common  to Tract IIA (tax  #303-1-2.1)  and the  herein
described  tract the following  courses and  distances,  N 67(Degree)  56' 30 E.
79.65  feet to a point;

Thence S  67(Degree)  03' 30 E.  67.51 feet to a point;

Thence  along  the line  common to Tract IIC (tax #  303-1-2.3)  and the  herein
described  parcel,  S  23(Degree)  00' 34 W.  32.79  feet to a  point;

Thence S 21(Degree) 59' 26 E. 40.22 feet to a point;

Thence S 66(Degree) 59' 26 E. 130.79 feet to a point;

Thence N 23(Degree) 00' 34 E. 83.09 feet to a point;

Thence N 21(Degree) 59' 26 W. 121.21 feet to a point;

Thence S 68(Degree) 00' 34 W. 21.36 feet to a point;

Thence N 36(Degree) 59' 26 W. 37.78 feet to a point;

Thence N 45(Degree) 30' 34 E. 41.22 feet to a point;

Thence N 44(Degree) 29' 26 W. 26.00 feet to a point;

Thence S  45(Degree)  30' 34 W. 20.71 feet to a point;

Thence along the line common to the aforementioned Tract IIA (tax #303-1-2.1)
and the herein described parcel the following courses and distances,N 22 Degree)
56' 30 E. 32.09 feet to a point;

Thence N 67(Degree) 03' 30 W. 185.05 feet to a point;

Thence S 22(Degree) 56' 30 W. 8.83 feet to a point;

Thence along the line common to the aforementioned Tract I (tax #303-1-2) and 
the herein described parcel for the following courses and distances, 
N 67(Degree)  03' 30 W. 79.00 feet to a point;

Thence S 22(Degree) 56' 30 W. 35.20 feet to a point;

Thence N 67(Degree) 03' 30 W. 7.65 feet to a point;

Thence along the line common to said property of Lewis Gale  Hospital,  Inc. 
(tax #283-2-1) and the herein  described  parcel the following  courses and 
distances,  N 22(Degree) 56' 30 E. 89.44 feet to a point;

                                       16


Thence S 70(Degree) 20' 51 E. 274.71 feet to a point;

Thence N 52(Degree) 19' 29 E. 14.21 feet to a point;

Thence S 67(Degree) 03' 30 E. 199.58 feet to a point;

Thence along the line common to property of Lewis Gale Building  Corporation  as
recorded  in Deed Book 81,  Page 298 (tax  #303.1-3)  and the  herein  described
parcel the following  courses and distances,  S 04(Degree) 00' 00 W. 350.42 feet
to a point,  said point lying on the northerly  right-of-way line of Keagy Road;

Thence along the line common to the northerly right-of-way of Keagy Road and the
herein described parcel the following courses and distances, N 86(Degree) 00' 00
W. 103.70 feet to a point of  curvature to the right;

Thence 323.98 feet along the arc of the curve to the right, whose radius is
980.00  feet,  tangent  163.48  feet,  delta angle  18(Degree)  56' 30 and chord
bearing and distance N 76(Degree) 31' 45 W. 322.51 feet to a point;

Thence N 67(Degree)  03' 30 W. 221.86 feet to the Point of BEGINNING containing
a computed acreage of 3.032 acres (132,062 SQ. FT.).

Together with appropriate  non-exclusive  easements of ingress and egress
over and along private  roads (now  existing or as may hereafter be  constructed
and/or  relocated)  of Lewis-Gale  Hospital,  Incorporated,  running  across its
remaining  lands  connecting  the subject  property  to Keagy Road and  Braeburn
Drive.  

Together also with easements for general utility  purposes over,  across
and under remaining properties of Lewis-Gale Hospital,  Incorporated,  including
water, sewer,  drainage,  electricity,  gas and telephone,  such easements to be
reasonable  and to be  exactly  located  as might  be  mutually  agreed  upon by
Lewis-Gale Hospital,  Incorporated,  and Industrial Development Authority of the
City of Salem,  Virginia,  their  successors  and assigns.

PARCEL II                 TRACT II-A (0.758 AC) 

Being a tract of land situated in Salem, Virginia, designated as Tract IIA,
containing 0.758 acre of land and designated at tax #303-1-2.1.

BEGINNING  at a  northeasterly  corner of Tract 1 (tax  #303-1-2),  a  southerly
corner of Tract IIB and a northwesterly  corner of the herein  described  tract;

Thence  along the line common to said Tract IIB and the herein  described  tract
the following courses and distance, N 22(Degree) 56' 30 E. 8.83 feet to a point;

Thence S 67(Degree) 03' 30 E. 185.05 feet to a point; Thence S 22(Degree) 56' 30
W.  172.33  feet along the  aforesaid  common  line and along the line common to
Tract IIC (tax #303-1-2.3) and the herein  described tract;

Thence N 67(Degree) 03' 30 W. 77.20 feet along  said  common  line and along the
line  common to the aforementioned  Tract IIB and herein described tract;

                                       17


Thence S 67(Degree) 56' 30 W. 79.65  feet to a point;

Thence N  22(Degree) 56' 30 E. 22.60 feet along the line  common to property
of Lewis Gale  Medical  Foundation  as recorded in Deed Book 26, Page 77 
(tax #303-1-1) and the aforementioned  tract to a point;

Thence N  67(Degree)  03' 30 W. 34.48 feet along said common line to a point;

Thence N 22(Degree)  56' 30 E.  55.02 feet along the line  common to the  
aforementioned Tract I (tax #303-1-2) and the herein described  tract;

Thence N 67(Degree) 03' 30 W. 16.97 feet along said common line to a point;

Thence N 22(Degree)  56' 30 E. 33.20 feet along said common line to a point;

Thence S 67(Degree)  03' 30 E. 16.97 feet along said  common  line to a point;

Thence N  22(Degree)  56' 30 E. 73.80 feet along said  common  line to a point;

Thence N  67(Degree)  03' 30 W. 17.05 feet along said  common  line to a point;

Thence N  22(Degree)  56' 30 E. 35.20 feet to the Point of BEGINNING and 
containing a computed  acreage of 0.758 acre (33,014 SQ FT).

Together with the following easements:

     (1) A non-exclusive easement for ingress, egress and parking on, over,along
and through all roads,  driveways and parking areas no existing and as hereafter
constructed or located on the remaining  property of the Industrial  Development
Authority of the City of Salem,  Virginia,  its successors and assigns,  located
between Keagy Road and Braeburn Drive.

     (2)  Such  easements  as  are   reasonably   necessary  for  the  location,
construction,  installation,  maintenance,  repair, removal,  reinstallation and
reconstruction  of utilities and utility  lines,  including  without  limitation
water, sewer, drainage,  electricity, gas and telephone, over, across, under and
through thr remaining  property of the Industrial  Development  Authority of the
City of Salem,  Virginia,  located between Keagy Road and Braeburn  Drive,  said
easements  to be  specifically  located by the mutual  agreement  of  Lewis-Gale
Building  Corporation  and the Industrial  Development  Authority of the City of
Salem, Virginia, their successors and assigns.

     (3) An  easement  for  the  lateral  support,  by the  eastern  wall of the
Lewis-Gale Clinic building now located on the land of the Industrial Development
Authority  of the  City of  Salem,  Virginia,  of the  building  constructed  by
Lewis-Gale Building corporation on the above-described land, including the right
to  insert  into and  attached  to said wall  such  beams  and other  structural
materials as shall be  reasonably  necessary  for the benefit and support of the
building constructed by Lewis-Gale Building Corporation; provided, however, that
such use shall not render unstable or unsafe or otherwise  materially  adversely
affect the  structural  integrity  of the building not located on Tract I (0.432
Ac.) as hereinabove described.

     (4) The easements for ingress and egress over and along existing and future
private roads connecting the hereinabove  described property with Keagy Road and
Braeburn  Drive and for  general  utility  purposes  over,  across and under the
property  of  Lewis-Gale  Hospital,  Incorporated,  which were  conveyed  to the
Industrial  Development Authority of the City of Salem,  Virginia, by Lewis-Gale
Hospital,  Incorporated,  by deed dated July 1, 1971,  recorded  in the  Clerk's
office of the  Circuit  Court of the City of Salem,  Virginia,  in Deed Book 17,
page  363,  to  which  deed  reference  is  hereby  made  for a more  particular
description  of said  easements,  said  easements  to be used in common with the
Industrial Development Authority of the City of Salem, Virginia, and its 
assigns.

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PARCEL III                  TRACT II-C (0.518 AC) 

Being a tract of land situated in Salem,  Virginia, and designated as Tract
IIC containing 0.518 acre of land and designated as tax #303-1-2.3.

BEGINNING  at a point  lying in the  easterly  property  line of Tract IIA,
being a  southerly  point of Tract IIB and being a  northwesterly  corner of the
herein described parcel, said point also lying S 22(Degree) 56' 30 W. 32.09 feet
from the northeast property corner of the aforementioned Tract IIA;

Thence along the line common to the aforesaid Tract IIB and the herein described
parcel the following  courses and distances,  N 45(Degree) 30' 34 E. 20.71 feet
to a point;

Thence S 44(Degree) 29' 26 E. 26.00 feet to a point;

Thence S 45(Degree) 30' 34 W. 41.22 feet to a point;

Thence S 36(Degree)  59' 26 E. 37.78 feet to a point;

Thence N 68(Degree) 00' 34 E. 21.36 feet to a point;

Thence S 21(Degree) 59' 26 E. 121.21 feet to a point;

Thence S 23(Degree) 00' 34 W. 83.09 feet to a point;

Thence N 66(Degree) 59' 26 W. 130.79 feet to a point;

Thence N 21(Degree) 59' 26 W. 40.22 feet to a point;

Thence N 23(Degree)  00' 34 E. 32.79 feet to a point;

Thence along the line common to said Tract IIA and the herein described parcel
the following courses and distances, S 67(Degree) 03' 30 E. 9.69 feet to a
point;  

Thence N 22(Degree)  56' 30 E. 140.24 feet to the Point of BEGINNING and
containing a computed acreage of 0.518 acre (22,563 SQ FT).acre (22,563 SQ FT).

                                       19