Should I sell my ophthalmology practice to private equity?

How the model works, and why your practice is the target

The platform buys a strong anchor practice, then adds smaller practices around it, and makes its return at the second sale, when the assembled platform is sold to a larger buyer at a higher multiple than the blended price paid to build it. The selling physicians participate in that second sale through their retained minority share, which is the pitch's most attractive element and its least certain one: the share pays only if the second sale happens, at a valuation nobody can promise, in a year the physicians do not choose. The surgery center is central to the platform's arithmetic, because the facility stream is the most durable earnings in the structure and the asset acquiring lenders understand best. A practice with a strong center and deep referral base is therefore a platform foundation as well as a good practice, and its owners should hear every offer with that in mind. The first valuation conversation prices the practice as earnings. The sophisticated seller also prices what the practice is worth as someone else's beginning.

What changes the day after

The physician becomes an employee of the platform, usually on a multi year agreement at a compensation set from the practice's prior earnings, and the items that were owner decisions become platform decisions in sequence: staffing levels, equipment purchases, payer contracting strategy, schedule templates, and eventually the second sale itself. Production expectations are commonly built into the post sale compensation, so the income that continues is tied to the volume that continues, and the covenant in the employment agreement governs what happens if the relationship ends early. None of this is hidden. It is the product being sold: the platform buys the right to run the practice, and pays for it. The seller's question is whether the cash, the retained share, and the employment years, summed honestly with the second sale discounted for its uncertainty, outweigh the alternative that is always available and rarely priced with the same care: keep the practice, take its distributions for the remaining career, and sell or wind it down at the end on the market for physician practices.

The household side of the sale is its own discipline. A closing produces a large taxable event in one year, arriving at the household's highest marginal rates, and the windfall lands inside a plan or it lands as lifestyle. The households that sell well decide the money's lanes before the closing: taxes reserved in full, the retirement funding consequences modeled, the remaining career's lower salary built into the spending plan, and the retained share carried on the balance sheet as the illiquid, uncertain asset it is rather than as found wealth. The estate and tax planning for a sale of this size is established stage work, engaged before the letter of intent, not after the wire.