STATE OF NORTH CAROLINA                                      FIRST AMENDMENT
                                                                    TO
COUNTY OF DURHAM                                           EMPLOYMENT AGREEMENT
     THIS FIRST AMENDMENT TO EMPLOYMENT AGREEMENT (this "Amendment") is made and
entered  into  effective  the 1st day of January,  1999 by and  between  COASTAL
PHYSICIAN  GROUP,  INC. ("the "Employer" or "Coastal"),  a Delaware  corporation
with its principal place of business in Durham,  North  Carolina,  and ▇▇▇▇▇▇ ▇.
▇▇▇▇▇▇▇▇, ▇▇. ("Employee"), a resident of Durham, North Carolina.
                               W I T N E S S E T H
                               -------------------
     WHEREAS,  Employer and Employee have previously  entered into an employment
agreement dated July 1, 1997 (the "Agreement") under which Employee is currently
employed by Employer; and
     WHEREAS,  Employer and Employee also desire to substantially and materially
modify the existing  terms of  employment  of Employee to, among other  matters,
increase his Base Salary, modify the Incentive Bonus structure,  and provide for
payment of earned divestiture bonuses;
     NOW,  THEREFORE,  in consideration of the terms and conditions set forth in
this  Amendment,  the parties hereby agree that the Agreement is hereby modified
as follows:
     1.  Replacement  of Exhibit A.  Exhibit A,  Compensation,  attached  to the
Agreement is hereby replaced by the Exhibit A dated January 1, 1999 and attached
to this Amendment.
     2. This Amendment  shall be an amendment and  modification to the Agreement
and shall  become  part of the  Agreement  and  employment  arrangement  between
Employee and Employer from and after the date of this Amendment. All capitalized
terms  not  defined  herein  shall  have the same  meaning  as set  forth in the
Agreement.  Any conflict  between terms of this Amendment and the Agreement will
be resolved in favor of this Amendment.  Except as amended herein,  all terms of
the Agreement shall remain in full force and effect.
     IN WITNESS WHEREOF, the parties have executed this Amendment as of the date
first above written.
                                         COASTAL PHYSICIAN GROUP, INC.
                                         By:______________________________
                                         Its:_____________________________
                                         ____________________________(SEAL)
                                         ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇
                                    EXHIBIT A
                                    ---------
                                  COMPENSATION
                                  ------------
                                 January 1, 1999
1. Base Salary. For services provided as an employee of Employer, Employee shall
receive,  beginning July 1, 1998, a base salary of $193,500 per annum (the "Base
Salary") payable in accordance with Employer's  current payroll  practices.  The
Base Salary shall be subject to annual review and  adjustment as of each January
1,  commencing  January 1, 2000 (or such  other  times as may be  determined  by
Employer), but if renewed by agreement of Employer and Employee, the Base Salary
shall  increase by seven and one-half  percent (7.5%) or by such other amount as
the  parties  may agree on to bring  Employee's  Base  Salary in line with other
senior  executives  (this  provision shall not create any right or obligation of
Employer or Employee to extend the term of this Agreement or to prevent Employer
and Employee from  extending upon such terms and conditions as they determine by
mutual agreement). Employee has been paid from July 1, 1998 through December 31,
1998 on the basis of an annual salary of $180,000 and so was  underpaid  $6,750,
which  amount shall be paid to Employee at the rate of $1,350 per month for five
months beginning  January,  1999 and continuing through May, 1999. These amounts
shall be added to and paid  with the  payouts  of  deferred  earned  divestiture
bonuses described Section 2 below.
2.  Earned  Divestiture  Bonuses.  Under  Section 3 of the  Exhibit A which this
Exhibit A replaces,  Employee was entitled to earn certain divestiture  bonuses.
Employer  acknowledges that Employee earned divestiture bonuses in the aggregate
amount of $56,387 which have not been paid, calculated as follows:
                                                  Transaction     Applicable
              Asset                              Consideration    Percentage     Bonus
              -----                              -------------    ----------     -----
                                                                           
       South Florida Clinics, Valley, Mebane     $     438,654       1.0%      $  4,387
       Cumberland Pediatrics                           150,000       1.0%         1,500
       IPN, PSI                                     10,100,000       0.5%        50,500
                                                                               --------
                                                                                $56,387
Employer has paid Employee $27,000 of the divestiture  bonus from funds received
from a settlement  of a legal  matter.  The balance of $29,387  shall be paid in
five  equal  monthly  installments  of  $5,877.40  beginning  January,  1999 and
continuing  through May, 1999. This amount shall be combined with the payment of
installments of deferred base compensation  under Section 1 (for a total monthly
payment of $7,227.40 per month during the five month period).
3. Incentive Bonus.  Employee acknowledges that no incentive bonuses were earned
under Section 2 of the prior Exhibit A. For 1999,  Employee shall be entitled to
an incentive or performance bonus (the "Incentive Bonus") of up to forty percent
(40%) of annual Base Salary, based on the following:
     (a) Employee  must be employed by Employer at the time the event  described
below occurs and at December 31, 1999 unless  employment  is  terminated  (i) by
Employer without
cause under Section 12(a), (ii) by death or disability of Employee under Section
12(d) where such death or  disability  occurs within the last four months of the
calendar year, or (iii) by Employee  because of a material breach by Employer as
provided in section 12(e).
     (b) Employee's  Incentive  Bonus shall be based on the following  criteria,
subject to a cap of 40% of annual Base Salary as previously indicated:
          (i)  10% of  Base  Salary  shall  be  earned  upon  the  closing  of a
     transaction  providing a complete or partial  replacement  of the Company's
     existing  securitization  financing  program  with a new bank loan,  credit
     facility,  securitization  or  financing  program,  an equity  infusion  or
     recapitalization  of the Company  and its  subsidiaries,  or an  additional
     capital or financing for the Company in addition to the existing facility.
          (ii) 0.5% of the "Transaction Consideration" paid shall be earned upon
     the closing of a transaction involving any significant merger,  acquisition
     or  divestiture   of  or  by  the  Company  or  any  of  its   subsidiaries
     ("significant" shall be understood to include any transaction, or series of
     transactions  that  are  related,   involving  purchase   consideration  or
     valuation   greater  than  $10,000,000  or  a  target  company  with  gross
     annualized   revenues   in  excess  of   $25,000,000).   The   "Transaction
     Consideration"  shall  be  understood  to mean  the  consideration  paid or
     calculated for purposes of compensating the Company's investment bankers on
     a  percentage  basis  as  such  term,  or its  equivalent,  is  used in the
     agreement between the Company and its investment  bankers retained for such
     transaction.
          (iii) 2.5% of Base Salary for each calendar  quarter in which Employer
     and its consolidated subsidiaries achieve a net profit (after all financing
     expenses) as reflected on the regularly  prepared  financial  statements of
     Employer.
          (iv) One percent (1%) of any amounts  recovered  after January 1, 1999
     by Employer or any of its  subsidiaries  for any  disputed  claims,  unpaid
     amounts  owed,  recoveries  from  bankruptcies,  reorganizations,  creditor
     arrangements or similar insolvency proceedings,  recoveries from litigation
     or claim settlements;  provided, however, this provision shall not apply to
     any matter in which Employee shall become a material witness.
          (v) up to 15% of Base Salary as determined solely in the discretion of
     Employer's Chief Executive Officer.
4. Stock  Options or Awards.  Employee  shall be eligible for stock  options and
awards available to other senior  management of Employer and its affiliates from
time to time. This subsection shall not be a guarantee of any awards or options,
and Employee  recognizes  that the awarding of such  compensation is governed by
plans adopted by the Board of Directors of Employer from time to time.
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