Practice Financial Strategy · 2026
Should You Sell Your Medical Practice to Private Equity?
What Most Physicians Get Wrong
The phone call usually starts the same way. A private equity-backed group introduces itself, mentions a number that sounds life-changing, and asks if you've ever considered "a transition." What they don't mention is what happens after you sign.
If you own a medical, dental, or specialty practice in 2025, you've almost certainly gotten that call. Private equity firms are aggressively targeting physician practices right now — sitting on an estimated $75 billion in uninvested healthcare capital with pressure to deploy it. For many practice owners, it feels like the tide is turning and maybe you should get out while the getting is good.
But here's what I've seen in my work guiding physicians through more than $45 million in healthcare acquisitions: most doctors sign away more than they realize — and far sooner than they planned.
This post is not anti-PE. It's pro-information. Before you take a meeting, here's what you actually need to know.
The PE Playbook — And Why You're Not the End Game
Private equity firms don't buy practices to run them forever. They buy them to consolidate them, grow revenue, and sell again — typically within 3 to 7 years. That's not a secret; it's the model. The problem is that most physicians don't fully absorb what that means for them personally until they're already in the contract.
What does it mean? It means your practice will likely be sold again — possibly multiple times — to buyers you've never met and didn't choose. Research published in JAMA Health Forum found that after PE firms exit their physician practice investments, doctor turnover increases significantly, and those physicians who leave tend to migrate to even larger corporate groups. The consolidation accelerates.
"They offered me a number I couldn't say no to. Two years later, I barely recognized the practice I'd spent 18 years building."
Composite of physician client conversations · MMAS CPA"Needing liquidity" and "wanting freedom" are two very different problems — and PE only solves one of them.
What the Term Sheet Doesn't Tell You
When a PE group sends over a letter of intent, the headline number is usually a multiple of EBITDA — your practice's earnings before interest, taxes, depreciation, and amortization. That number looks great. What's buried in the pages that follow is what should concern you.
Questions to Ask Before You Respond to Any PE Offer
- ✦What percentage is cash at close vs. rollover equity — and when does that equity actually pay out?
- ✦What are the earn-out provisions — and what metrics determine whether you receive them?
- ✦What do your post-acquisition employment terms say about clinical autonomy, staffing decisions, and compensation?
- ✦Non-compete clause — how does it affect your options if you leave or the practice is resold?
- ✦Was the EBITDA actually normalized — was anything added back that a buyer might later dispute?
- ✦Who controls billing, vendor contracts, and overhead after close?
The valuation conversation is the easy part. The due diligence and deal structure conversation is where practice owners lose leverage — and most physicians walk into it without a healthcare-specialized CPA by their side.
Our Practice Readiness Assessment gives you a clear financial picture — including a valuation baseline, profit leak analysis, and exit readiness score.
Start the Assessment → $2,500 · Includes 60-min debriefThe Alternative Most Physicians Never Hear About
Here's the question I always ask physicians who are considering a PE deal: What are you actually trying to solve?
In my experience, the answer is almost never "I want to hand my practice to an investment firm." The real answers are things like: I'm burned out from administrative burden. I want to take income off the table without waiting another decade. I want to work less without earning less. I want to protect what I've built from the next acquisition wave.
Those are solvable problems — without selling. The Exit Without Selling™ framework I've developed with MMAS CPA is built specifically for this — making sure a sale becomes a choice, not a survival move.
The Exit Without Selling™ Framework — Core Pillars
- ✦Practice Profitability Optimization — Closing the profit leaks that silently drain 10–20% of revenue in most practices
- ✦Owner-Independent Operations — A practice that runs without you at the center, increasing value and reducing burnout
- ✦Tax-Efficient Wealth Extraction — Moving income off the practice's balance sheet into personal wealth vehicles before any sale
- ✦AI-Ready Financial Infrastructure — The reporting and visibility that buyers pay premium multiples for, available to you right now
- ✦Exit-Readiness Scoring — Know exactly where you stand on a sophisticated buyer's checklist
The Physician Freedom Roadmap™ maps a personalized 24–36 month path to financial independence — whether or not you ever sell. The goal: the next PE call feels like an option, not an ultimatum.
How to Know Where You Actually Stand
Most practice owners I work with are shocked by what they don't know about their own numbers. The financial reporting most practices have is built for tax compliance — not strategic decision-making. If you're feeling any uncertainty about your practice's future, get clear on these three numbers:
1. Your true profitability — not your taxable income
2. Your practice's current market value — based on what buyers are actually paying today
3. Your personal financial gap — the distance between what you have and what you need to be free
Those three numbers change everything about how you respond to the next PE call. Or whether you need to respond at all.
Find Out Where Your Practice Really Stands
A complete financial diagnostic — profitability, exit readiness, and a personalized debrief with our healthcare CPA team.
Get Your Practice Assessment →$2,500 · Includes 60-minute strategy debrief · Healthcare practices only
Tina McGill, CPA
Tina is the founder of MMAS CPA, a healthcare-exclusive advisory firm serving medical, dental, and specialty practices across Tennessee and Florida. She has guided physicians through more than $45 million in practice acquisitions, speaks at national healthcare and CPA conferences including AAO events, and is the architect of the Exit Without Selling™ framework and the Physician Freedom Roadmap™.
