To Private Equity or not to Private Equity?

To Private Equity or not to Private Equity?

Here’s a tool you can use. Consider the following questions to assess whether PE investments might be worth exploring for you.


Score yourself (and/or your practice) on a scale of 1 to 5.


Your response

(on a scale of 1 to 5)


Is there a lot of competition in your area?

1 – low (we dominate our area)

2 – somewhat low (only a few groups offer what we do)

3 – moderate (there’s competition but it’s not threatening)

4 – high (there’s high competition for what we do)

5 – very high (weworry about losing patients to competition all the time)


How are your practice financials?

1 – weak (we are barely surviving)

2 – somewhat weak (we are in losses year after year)

3 – moderate (we spend all that we make)

4 – strong (we do make reasonable profits)

5 – very strong (we are highly profitable)


Are you under pressure from your hospital?         

1 – no pressure (hospitals are desperate for our services)

2 – some pressure (we are watchful)

3 – moderate pressure (hospitals keep making us offers)

4 – threat (there’s ongoing threat from hospitals)

5 – strong threat (we strongly fear that hospitals will grab our referral base)


Do you have reasonable contracts from your insurance companies?

1 – weak (poor contracts or I don’t know)

2 – somewhat weak (competition seems to have better rates than we do)

3 – moderate (we have okay rates but could do better)

4 – strong (we get paid well on important services)

5 – very strong (we are able to periodically increase our rates and get paid)


Is your billing maximized?         

1 – very poor (we lose a lot of money or I don’t know)

2 – poor (we keep leaving money on the table)

3 – moderate (we could do much better)

4 – good (our billing is effective)

5 – fully maximized (we collect maximum possible)


Are you entrepreneurial?

1 – not at all (I keep out of all non-clinical aspects)

2 – somewhat (I do whatever is needed)

3 – moderately (can’t say one way or the other)

4 – highly (I enjoy managing the practice and others)

5 – very highly (I’m often seen as the connector in my region)


Are you frustrated with administrative work (billing, staffing etc.) you need to do to stay in practice?

1 – very frustrated (I detest everything outside of clinical work)

2 – frustrated (I limit myself to only those tasks that are absolutely needed)

3 – moderately tired (I tolerate administrative work)

4 – energized (I enjoy administration)

5 – highly energized (I excel at practice administration)


Are you close to retirement?       

1 – very early (just got started)

2 – early (many years left)

3 – in the middle

4 – close (few years left)

5 – very close (almost there)


How are relations amongst partners in your practice?       

1 – weak (we dislike working with each other)

2 – somewhat weak (we tolerate each other)

3 – moderate (sometimes ok, sometimes not)

4 – strong (cordial relations)

5 – very strong (we have fun together)


How comfortable are you with forgoing autonomy in non-clinical decisions?

1 – definitely uncomfortable

2 – somewhat uncomfortable

3 – moderately comfortable

4 – somewhat comfortable

5 – quite comfortable


If your colleagues sell to PE and make money, how would that make you feel?

1 – miserable

2 – bothersome

3 – somewhat bothersome

4 – almost no effect

5 – makes absolutely no difference to my life


Seller’s remorse is a feeling of regret after acquisition. If you sell out and things don’t go as planned, how would that make you feel?

1 – highly confused (I’d be frustrated)

2 – confused (I’d look for ways to buy back)

3 – somewhat frustrated

4 – progressive (I’d look ahead to make the best of the decision)

5 – highly progressive (I’d focus on making the decision right)

If you decide to explore the PE route, the first step would be to educate yourself with your options.