Don't underestimate what a small, highly qualified team can do — take Boston's Steward Health Care System. Established only in 2010, it is the second-largest health system in New England with 11 hospitals, more than 2,000 physicians and 17,000 employees. Overseeing the buildup are seven attorneys who handle the bulk of the transactions, often without the help of outside counsel. "We are a very diverse group in terms of both talent and lifestyle," said general counsel Joseph Maher Jr.

As the former general counsel and executive vice president of government affairs at Caritas Christi Health Care, which ran six hospitals, Maher spearheaded that system's sale to New York City-based Cerberus Capital Management, giving birth to the new for-profit Steward Health Care System. Since then, his team has overseen the acquisition of four community hospitals and the takeover of post-acute care provider New England Sinai Hospital, attracting large groups of doctors in the process.