Here’s one of the most logical mistakes I see in healthcare.
A physician builds a great practice. It’s working. It’s profitable.
So the thinking goes: “Let’s open a second location that looks exactly like this one. Double the locations, double the profit.”
It makes total sense. I’d probably think the same thing if I hadn’t watched how it usually plays out.
That’s not how private equity grows practices. I spent years on that side, and here’s what they do differently:
They centralize every function they can. Billing, scheduling, HR, purchasing, credentialing. Anything that doesn’t need to happen in the exam room.
They build a staffing matrix across locations, instead of copying one site’s staffing over and over.
And they keep the clinical expertise where it belongs: in the field, with patients.
Going from one clinic to two, you shouldn’t keep the same staffing model. You’re now staffing two clinics, not one clinic twice.
At 20 clinics, it’s a completely different pattern again. Not one, one, one, one, twenty times over.
This is genuinely hard. And most physicians running one or two sites have simply never seen multi-site operations from the inside. Why would anyone expect them to know how to build it?
But it’s the difference between growth that compounds and growth that multiplies your problems.
If you’re planning a second location: are you building a copy of your first one, or a system that can run both?
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