A dental practice being acquired by a DSO is typically valued on EBITDA (earnings before interest, taxes, depreciation, and amortization) using a multiple that reflects the practice's quality, growth, and patient demographics. A physician practice being acquired by a hospital system or a private equity-backed management services organization (MSO) may be valued differently, with additional weight given to facility ownership, specialist mix, and referral relationships.
What outside buyers focus on, specifically:
Physical assets and lease structure, owned versus leased real estate; equipment condition; lease terms.
Understanding these metrics before an offer arrives is the difference between being able to negotiate and simply reacting to what someone else has decided your practice is worth. Raymond James does not guarantee any specific valuation outcome.
You Built a Practice.Private Equity Has Noticed. Now What?
Private equity groups and dental service organizations are acquiring healthcare practices at a rate that would have seemed unusual ten years ago. If you own a physician practice, a dental practice, an imaging center, or a specialty group in Connecticut or Westchester County, there is a reasonable chance someone has already approached you about buying it.
Most physicians and dentists who receive these offers don't have a financial advisor who understands the transaction. They have an accountant who handles the taxes, an attorney who reviews the contract, and a wealth advisor who manages their portfolio. None of those three typically specializes in helping a practice owner understand what the business is worth, whether the offer is fair, and what the financial life looks like after the deal closes.
That gap is exactly what Westport Wealth Partners addresses. Matthew T. Streif, CEPA® and Nicholas DiFalco, APMA® CEPA® have worked with healthcare practice owners on financial planning for the full scope of the practice transition, from understanding current valuation to building the income plan for after the sale. And through Raymond James investment banking, the firm has access to transaction expertise that most wealth advisory practices cannot offer.
Selling to a DSO, Hospital System, or PE GroupWhat Is the Difference?
The three most common buyer types for healthcare practices have very different deal structures and very different implications for the practice owner post-close.
Raymond James investment banking access is a differentiator for this process: the firm can coordinate with investment bankers who have healthcare industry transaction experience, rather than relying solely on the buyer's representation.
After the SaleReplacing a Healthcare Income Stream
The financial planning challenge that surprises most healthcare practice owners is what happens to their income after the deal closes.
For most owner-physicians and dentist-owners, the practice has been the primary income source for 15 to 30 years. It has generated a predictable, substantial cash flow. After a sale, even one that includes a continued employment arrangement, the income picture changes materially.
A lump-sum payout creates a one-time planning event, not an ongoing income stream. An employment arrangement creates predictable income for a defined period, but that period ends. And the tax treatment of the proceeds, how much goes to ordinary income versus capital gains, affects what remains to be invested.
Building a personal investment portfolio that can generate the income needed to replace practice earnings over the long term is the core financial planning challenge for healthcare practice owners post-sale. That plan needs to be built before the sale closes, not after the check clears.
Westport Wealth Partners builds this plan in coordination with your CPA. Raymond James does not provide tax or legal services.
Financial Planning for Physicians Beyond the Practice
Not every Connecticut physician owns a practice. Employed physicians at hospital systems, academic medical centers, and large specialty groups have distinct financial planning needs that are equally complex.
Many hospital systems offer deferred compensation plans for employed physicians. Timing decisions about deferrals affect both liquidity and tax treatment over a multi-year horizon, coordinate with your CPA.
Base salary, RVU-based production bonuses, research funding, call compensation, and benefits vary significantly. Understanding the total compensation picture is the starting point for financial planning.
High-earning physicians often accumulate significant investable assets over careers: managing those assets efficiently, reducing concentration risk, and building a retirement income plan alongside a demanding career requires deliberate planning.
The intersection of professional liability exposure and personal wealth protection is a planning area where a financial advisor works in coordination with your malpractice insurer and an attorney.
Frequently Asked Questions for Healthcare Practice Owners
How do I know if an offer to buy my practice is fair?
Evaluating a practice acquisition offer requires understanding how the buyer arrived at their valuation: the multiple used, what revenue or EBITDA basis was applied, and what assumptions are embedded in the offer. An independent perspective on practice valuation, alongside a full review of deal terms by a healthcare attorney, helps ensure you understand what you are accepting. Westport Wealth Partners helps healthcare owners put an offer in the context of their full financial plan. Raymond James does not provide tax or legal services.
Should I sell my practice now or wait?
The right timing depends on your personal financial position, the current M&A environment for your specialty, your practice's financial performance, and your post-sale goals. There is no universal answer: the decision requires individual analysis of your financial plan, your practice's value trajectory, and the specific terms being offered. We help healthcare practice owners evaluate these factors together rather than in isolation.
I'm an employed physician, not a practice owner. Do you work with me?
Yes. Employed physicians have distinct financial planning needs including deferred compensation management, restricted stock units, understanding contract compensation structures, and building personal wealth independent of employer equity. Westport Wealth Partners works with employed healthcare professionals as well as practice owners.
What happens to my income after I sell my practice?
After a practice sale, the active business income typically stops or transitions to an employment arrangement with the acquiring entity. The financial planning challenge is building a personal investment portfolio that can generate the income needed to replace the practice earnings over the long term. This transition plan needs to be in place before the sale closes, not after. The post-sale financial plan must also account for the tax treatment of the sale proceeds.
What are the tax implications of selling a medical or dental practice?
Practice sale tax implications depend on the deal structure, asset sale versus stock or membership interest sale, the allocation of purchase price among asset categories, and applicable federal and state tax rates. These decisions have a significant impact on after-tax proceeds. Raymond James does not provide tax or legal services. We strongly recommend coordinating with a qualified CPA who has experience in healthcare practice transactions before any sale is finalized.
My practice has multiple partners. How does that affect exit planning?
Multi-partner practices introduce additional planning considerations, including buy-sell agreement review, right-of-first-refusal clauses, partner equity valuation methodology, and coordination of each partner's individual financial plan with the group exit timeline. These agreements typically require review by a healthcare attorney. Westport Wealth Partners helps each partner understand how the group transaction affects their individual financial plan.
Do you have experience with dental practice DSO sales specifically?
Yes. Dental practice DSO acquisitions have specific characteristics including rollover equity requirements, employment contract terms, and earnout structures that differ from other healthcare transactions. Westport Wealth Partners helps dental practice owners evaluate DSO offers in the context of their full financial plan and can coordinate with Raymond James investment banking for qualified transactions.
