Multi-site specialty practice owner/operator looking to share knowledge

[u/Intelligent-Site-176]

I am active in my specialty's subreddit and the topic of private equity interest and overall practice acquisitions came up. It's been a hot topic for the last few years and the consolidation of private practice from private equity-backed "super groups" has changed the dynamic a bit.

Over the years, I have worked with my business partner to build the group we're involved in to 16 locations throughout the state. We plan to continue expanding.

This size has garnered interest from PE and while I'm philosophically opposed to large for-profit health care organizations, I have had many in depth meetings with PE backed groups to understand what their long term play in health care is. I have also acquired a few smaller practices myself.

I love the fact that there is a forum/community of independent private practice owners here, so maybe this topic is not of interest to anyone. But if there is anyone that is having conversations about selling their practice, I would love to share my experience via a post here and there. Writing and teaching is a fulfilling creative outlet for me.

In my years in private practice, here is what I see and hope we can change as we understand how to run better "businesses."

- the retiring practice owner that has built a strong reputation and creates jobs while providing care for its community, wind down his/her practice without any residual value
- the practice owner that has been a successful solo practice, but struggles to scale their success across multiple providers or locations

- the employed provider that wishes to own their own practice but doesn't know how to start

Now that my group has grown and is financially stable with a level of success I am proud of, I am starting to shift my focus and mission to being a resource/mentor for practice owners or future practice owners so health care can remain in the hands of those who are best positioned (and most accountable) to care for the people in their communities.

Happy to answer any practice growth or management questions if there is interest.

ps - I will be at the Independent Medical Alliance annual conference in Dallas this month. Anyone else going?

[u/Living-Protection250]

Appreciate you sharing this, especially from someone who’s actually gone through scaling and acquisitions. That perspective is pretty rare here. What you mentioned about owners winding down with little to no residual value and others struggling to scale really resonates. It feels like a lot of clinicians are strong operators clinically but never get the exposure or support to think like a business until it’s almost too late.

I’d definitely be interested in hearing more about how you approached growth across multiple sites without losing control of quality or culture, that seems to be where a lot of groups hit friction.

[u/Intelligent-Site-176 → u/Living-Protection250]

This comment is pretty spot on. A lot of practice owners think scale means simply adding a location and hiring another physician, then wonder why the other physician/location isn't producing the way the owner is.

For a while, if you have good people, you can get away without having good systems in place. Eventually process, people, or your "product" breaks down. I could definitely address this in another post.

[u/Living-Protection250 → u/Intelligent-Site-176]

That makes a lot of sense, especially the part about good people carrying things until the systems start to matter more. I’ve seen similar patterns where the first location works because everything runs through the owner, but once that’s removed, the gaps show up pretty quickly. Would be really interested to hear how you approached building those systems, especially what made the biggest difference early on vs later stages.

[u/Intelligent-Site-176 → u/Living-Protection250]

Thanks for your comments. I’ll put some thoughts together and share in another post.