Most conversations I have with owners about the future start the same way: "We either sell, or we keep doing what we’re doing."
Two doors. But after years on every side of these deals (hospital, private equity, and now alongside owners), I’ve learned there are almost always more than two.
Here are five I’d put on the table before anyone signs anything:
1. Stay independent, but stronger. Fix the economics, build the leadership, and make independence a choice instead of a hope.
2. Buy out the senior partner. If one partner wants out and the others want to stay, a planned buyout over several years can solve both problems.
3. A joint venture with a hospital. Keep part of what you built while sharing capital and risk.
4. A private equity partnership. Done with clear eyes, it can be the right answer for some groups.
5. Become the practice a health system can’t ignore. Get strong enough that if you do sell, you sell at the top of the market and keep seats on the board.
I’m not for or against any of these. Every transaction isn’t a bad transaction. Selling is the right answer when the owners have decided they want to capitalize on what they’ve built, and they understand that things won’t be the same afterwards. What worries me is when it’s the only option anyone looked at.
Because options aren’t created the week an offer arrives. They’re built years before it.
Which of these five has your group actually sat down and discussed?
Originally published on LinkedIn.
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